Organization Active NPI

Circle Family Care

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1124134515
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CIRCLE FAMILY CARE
Practice address
1633 N Hamlin
Chicago, IL 60647-4607
Phone
(773) 276-1200
Fax
(773) 276-8285
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Reuben J Pettiford
Title
Chief Executive Officer
Phone
(773) 379-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X IL Primary

Addresses

Primary practice location

1633 N Hamlin
Chicago, IL 60647-4607

Mailing address

5002 W Madison St
Chicago, IL 60644-4127
Phone (773) 379-1000

National Provider Directory

National Provider Directory

Locations

1633 N Hamlin Ave
Chicago, IL 60647
Phone (773) 276-1200

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124134515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606444127",
            "telephone_number": "773-379-1000",
            "fax_number": "773-379-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 N HAMLIN",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474607",
            "telephone_number": "773-276-1200",
            "fax_number": "773-276-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIRCLE FAMILY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PETTIFORD",
        "authorized_official_first_name": "REUBEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "773-379-1000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.