Individual provider Active NPI

Joumana Tannous Chaiban, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Merrionette Park, IL
National Provider Identifier
1124233291
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036-133347 Issued in IL
Practice address
11600 S Kedzie Ave Ste D
Merrionette Park, IL 60803-6308
Phone
(708) 684-6867
Fax
(708) 684-6869
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2015013437 MO
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036-133347 IL Primary

Addresses

Primary practice location

11600 S Kedzie Ave Ste D
Merrionette Park, IL 60803-6308

Mailing address

660 S Euclid Ave
C B 8127
Saint Louis, MO 63110-1010
Phone (314) 747-3000

Other practice location 1

4921 Parkview Pl
Ste 13B
Saint Louis, MO 63110-1032
Phone (314) 747-3000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jchaiban205578@direct.myadvocateaurora.org Direct
FHIR URL https://EPICFHIR.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160714001442 IL Practitioner - Endocrinology 7517154644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11600 S Kedzie Ave
Merrionette Park, IL 60803-6307
Phone (708) 272-4150

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

4440 W 95TH St
Oak Lawn, IL 60453-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Aug 1, 2016 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Aug 1, 2016 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

11600 S Kedzie Ave
Ste D
Merrionette Park, IL 60803
Phone (708) 389-2200

Interoperability endpoints

  • Direct secure messaging: jchaiban205578@direct.myadvocateaurora.org

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1124233291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "C B 8127",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-747-3000",
            "fax_number": "314-747-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 S KEDZIE AVE STE D",
            "city": "MERRIONETTE PARK",
            "state": "IL",
            "postal_code": "608036308",
            "telephone_number": "708-684-6867",
            "fax_number": "708-684-6869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4921 Parkview Pl",
            "address_2": "Ste 13B",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101032",
            "country_code": "US",
            "telephone_number": "314-747-3000",
            "fax_number": "314-747-7065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAIBAN",
        "first_name": "JOUMANA",
        "middle_name": "TANNOUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "2015013437",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036-133347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jchaiban205578@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11600 S Kedzie Ave Ste D",
            "city": "Merrionette Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608036308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EPICFHIR.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11600 S Kedzie Ave Ste D",
            "city": "Merrionette Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608036308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Merrionette Park, IL

Sources for this page

Verify at the official NPI Registry.