Active NPI
Pooja Agrawal, MD
- Pediatrics Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036152089
- Practice address
- 1701 W Superior St FL 2
Chicago, IL 60622-5646 - Phone
- (312) 666-3494
- NPI assigned
- Jun 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 125070633 | IL | |
| Pediatrics Physician | 208000000X | 036152089 | IL | Primary |
Addresses
Primary practice location
1701 W Superior St FL 2
Chicago, IL 60622-5646
Mailing address
1701 W Superior St FL 2
Chicago, IL 60622-5646
Phone (312) 666-3494
Other practice location 1
5841 S Maryland Ave # 8016
Chicago, IL 60637-1447
Phone (773) 702-6435
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036152089 | IL | MD | Pediatrics Physician |
| 125070633 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Erie Family Health Center, Inc | Current | Accepting new patients | |
| Erie Family Health Center Inc | Current | Accepting new patients | |
| Erie Family Health Center Inc | Current | Accepting new patients |
Locations
1701 W Superior St
Chicago, IL 60622
Phone (312) 432-7392
1701 W Superior St
Fl 2
Chicago, IL 60622
Phone (323) 361-2122
1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381
1701 W Superior St
#3
Chicago, IL 60622
1504 S Albany Ave
Chicago, IL 60623
Interoperability endpoints
- pagrawal368054@direct.ochin.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1760499545
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1043407547
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1548062318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628467200000",
"number": "1063941995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 W SUPERIOR ST FL 2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606225646",
"telephone_number": "312-666-3494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 W SUPERIOR ST FL 2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606225646",
"telephone_number": "312-666-3494"
}
],
"practiceLocations": [
{
"address_1": "5841 S Maryland Ave # 8016",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606371447",
"country_code": "US",
"telephone_number": "773-702-6435",
"fax_number": "773-834-0748",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AGRAWAL",
"first_name": "POOJA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-05",
"last_updated": "2021-08-09",
"certification_date": "2021-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "125070633",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036152089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.