NPIMap

Individual provider Active NPI

Charles Edoigiawerie, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1073622957
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-100884 Issued in IL
Practice address
500 E 51St St
Chicago, IL 60615-2400
Phone
(312) 572-2675
Fax
(312) 572-2669
NPI assigned
Aug 30, 2006
Last updated
Apr 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-100884 IL Primary

Addresses

Primary practice location

500 E 51St St
Chicago, IL 60615-2400

Mailing address

1901W Harrison St
Chicago, IL 60612-3714
Phone (312) 864-3500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cedoigiawe@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050720000641 IL Practitioner - Family PracticePractitioner - Emergency Medicine 5991732091 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians
Emergency Medical Specialists II SCGroup PAC ID 6002711603, 8 clinicians

Practice addresses (Care Compare)

1135 W 69TH St
Chicago, IL 60621-1147
Phone (773) 483-5011

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

3435 W Van Buren St
Chicago, IL 60624-3312
Phone (773) 826-6300

500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-100884ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Current Accepting new patients
Emergency Medical Specialists, II, S.C. CurrentSince Feb 23, 2014 Accepting new patients
Emergency Room Care Providers, S.C. PastSince Jul 25, 2019 Accepting new patients
Family Guidance Centers, Inc. PastSince Aug 16, 2022 Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

3435 W Van Buren St
Chicago, IL 60624
Phone (773) 265-7700

34816 Eagle Way
Chicago, IL 60678

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

Interoperability endpoints

  • Direct secure messaging: cedoigiawe@direct.ccprovider.org
  • Direct secure messaging: cedoigiawerie@direct-address.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 33

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 33

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1073622957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E 51ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606152400",
            "telephone_number": "312-572-2675",
            "fax_number": "312-572-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDOIGIAWERIE",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-100884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cedoigiawe@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.