Active NPI
Cedric L Coleman, MD
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1104809755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036067164
- Practice address
- 10719 S Western Ave
Chicago, IL 60643-3135 - Phone
- (773) 941-5156
- Fax
- (708) 229-1611
- NPI assigned
- Nov 28, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036067164 | IL | Primary |
Addresses
Primary practice location
10719 S Western Ave
Chicago, IL 60643-3135
Mailing address
10719 S Western Ave
Chicago, IL 60643-3135
Phone (773) 941-5156
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036067164 | Medicaid | IL |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110222000990 | IL | Practitioner - Internal Medicine | 8729269899 | Practice locations: Chicago, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
10801 S Western Ave
Suite 205
Chicago, IL 60643-3225
Phone 7082291600708229
Hospital & facility affiliations
- Comfort Care LLC
- Advocate Trinity Hospital
- Osf Little Company of Mary Medical Center
- Advocate Christ Hospital & Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GICBCA/Endpoint/GICBCA
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hazel Crest, IL
- NPI 1467560128
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- General Acute Care Hospital
- Oak Lawn, IL
- NPI 1548375082
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1558479212
-
- Home Health Agency
- Chicago, IL
- NPI 1801128962
-
- General Acute Care Hospital
- Evergreen Park, IL
- NPI 1215572045
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775606400000",
"number": "1104809755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10719 S WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606433135",
"telephone_number": "773-941-5156",
"fax_number": "708-229-1611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10719 S WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606433135",
"telephone_number": "773-941-5156",
"fax_number": "708-229-1611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "CEDRIC",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-28",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036067164",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036067164",
"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 Apr 8, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.