Organization Active NPI

First Clinic SC

  • Internal Medicine Physician
  • Skokie, IL
National Provider Identifier
1114932555
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FIRST CLINIC SC
Practice address
9669 Kenton Ave
#405
Skokie, IL 60076-1266
Phone
(847) 933-0500
Fax
(847) 933-0505
NPI assigned
Jul 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Authorized official

Name
Dr. Chris Chon, MDNPI 1578550752
Title
Physician
Phone
(847) 933-0500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

9669 Kenton Ave
#405
Skokie, IL 60076-1266

Mailing address

PO Box 5177
Skokie, IL 60076-5177
Phone (847) 933-0500

Other identifiers 2

IdentifierTypeStateIssuer
31604612OtherILBCBSIL
036084803MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070426000532 IL Part B Supplier - Clinic/Group Practice 9335245000 Receives reassigned benefits from 1 practitioner
Practice locations: Skokie, IL; Park Ridge, IL; Evanston, IL; Glenview, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0950920First Kare Multispecialty Clinic9669 N Kenton Ave, Ste 405, Skokie, IL 60076Certificate of waiverSep 8, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1114932555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5177",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600765177",
            "telephone_number": "847-933-0500",
            "fax_number": "847-933-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE",
            "address_2": "#405",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761266",
            "telephone_number": "847-933-0500",
            "fax_number": "847-933-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-01-23",
        "status": "A",
        "authorized_official_last_name": "CHON",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "847-933-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "31604612",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084803",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.