NPIMap

Organization Active NPI

Triad Hospitalist Group SC

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1144456310
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TRIAD HOSPITALIST GROUP SC
Practice address
5645 W Addison St
Chicago, IL 60634-4403
Phone
(773) 282-7000
NPI assigned
Jun 2, 2009
Last updated
Jun 29, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Authorized official

Name
David J Bordo, MDNPI 1184624298
Title
Chairman
Phone
(773) 282-7000

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 Physician 207R00000X NU Primary

Addresses

Primary practice location

5645 W Addison St
Chicago, IL 60634-4403

Mailing address

520 E 22ND St
Lombard, IL 60148-6110
Phone (630) 874-2542

National Provider Directory

National Provider Directory

Locations

75 Remittance Dr
Dept 1375
Chicago, IL 60675

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246233600000",
    "number": "1144456310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 22ND ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486110",
            "telephone_number": "630-874-2542",
            "fax_number": "630-874-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344403",
            "telephone_number": "773-282-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD HOSPITALIST GROUP SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-29",
        "status": "A",
        "authorized_official_last_name": "BORDO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "773-282-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "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 Jun 29, 2009; 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.