Active NPI
Rita C Tallud, MD
- General Practice Physician
- Chicago, IL
National Provider Identifier
1073642989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Practice address
- 2875 W 19TH St
Chicago, IL 60623 - Phone
- (773) 484-1000
- NPI assigned
- Mar 5, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | IL | Primary |
Addresses
Primary practice location
2875 W 19TH St
Chicago, IL 60623
Mailing address
4177 S Archer Ave
Chicago, IL 60632
Phone (773) 254-2222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1627765 | Other | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036050656 | IL | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073642989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4177 S ARCHER AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60632",
"telephone_number": "773-254-2222",
"fax_number": "773-254-8444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2875 W 19TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60623",
"telephone_number": "773-484-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TALLUD",
"first_name": "RITA",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "1627765",
"state": null
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.