Milton Daugherty, MD

Key facts

NPI

1124100896

Entity type

Individual (NPI type 1)

Primary specialty

Psychiatry Physician 2084P0800X

License

O36-048434 (IL)

Practice address

7531 So Stony Island
Chicago, IL 60649

Phone

(773) 947-7900

Fax

(773) 947-7901

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tca Health Inc NFP Federally Qualified Health Center (FQHC) · Chicago, IL · NPI 1184757353
  Medicare reassignment NPD IL
• Jackson Park Hospital Foundation General Acute Care Hospital · Chicago, IL · NPI 1497750699
  NPD
• Tca Health Inc NFP Federally Qualified Health Center (FQHC) · Hammond, IN · NPI 1093404576
  NPD

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: miltondaugherty@jph.medalliesdirect.net

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 4, 2013.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1124100896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 S KENWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606152016",
            "telephone_number": "773-947-7900",
            "fax_number": "773-947-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7531 SO STONY ISLAND",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60649",
            "telephone_number": "773-947-7900",
            "fax_number": "773-947-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "MILTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "O36-048434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BS",
            "identifier": "0021609983",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "O36048434",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "O36048434",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

• Asif N Daud, MD
• Alyssa Jeanette Daugherty, FNP-C
• Christopher Daugherty
• Karen Daugherty, M.D.
• Levi Daugherty, DO
• Syndee Daugherty
• Caitlin Daughtry
• Lisa M Daul Ruben, PA-C
• Jordan Daul
• Julie L Daum, PT

All providers in Chicago, IL · Psychiatry Physician in Illinois