Southeast Chicago Neurology Associates SC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

SOUTHEAST CHICAGO NEUROLOGY ASSOCIATES SC

Practice address

2850 S Wabash Ave
Suite 102
Chicago, IL 60616-2955

Phone

(312) 496-3488

NPI assigned

Jan 11, 2016

Last updated

Jan 11, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anil Gulati, MDNPI 1003899428

Title

Owner

Phone

(312) 496-3488

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anil K Gulati, MD

  • Neurology Physician
  • Chicago, IL
  • NPI 1003899428
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452470400000",
    "number": "1073979761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 S WABASH AVE",
            "address_2": "SUITE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 S WABASH AVE",
            "address_2": "SUITE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162955",
            "telephone_number": "312-496-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST CHICAGO NEUROLOGY ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-01-11",
        "status": "A",
        "authorized_official_last_name": "GULATI",
        "authorized_official_first_name": "ANIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-496-3488",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kimberly Souther
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• Karl Southgate, PSY.D., L.P.C.

• Neurology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.