Active NPI
Ernestine Hambrick, M.D.
- Colon & Rectal Surgery Physician
- Chicago, IL
National Provider Identifier
1073743209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Colon & Rectal Surgery Physician
- License
- 036.042220
- Practice address
- 1340 S Damen Ave
Suite 200
Chicago, IL 60608-1169 - Phone
- (312) 997-7200
- Fax
- (312) 997-7250
- NPI assigned
- Jul 22, 2009
- Last updated
- Jul 22, 2009
- 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 |
|---|---|---|---|---|
| Colon & Rectal Surgery Physician | 208C00000X | 036.042220 | IL | Primary |
Addresses
Primary practice location
1340 S Damen Ave
Suite 200
Chicago, IL 60608-1169
Mailing address
1340 S Damen Ave
Suite 200
Chicago, IL 60608-1169
Phone (312) 997-7200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036.042220 | Medicaid | IL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.042220 | IL | MD | Colon & Rectal Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248220800000",
"number": "1073743209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1340 S DAMEN AVE",
"address_2": "SUITE 200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606081169",
"telephone_number": "312-997-7200",
"fax_number": "312-997-7250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1340 S DAMEN AVE",
"address_2": "SUITE 200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606081169",
"telephone_number": "312-997-7200",
"fax_number": "312-997-7250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMBRICK",
"first_name": "ERNESTINE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-22",
"last_updated": "2009-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "IL",
"license": "036.042220",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036.042220",
"state": "IL"
}
],
"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 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.