Active NPI
At Your Door Physician Care
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1154901783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- AT YOUR DOOR PHYSICIAN CARE
- Practice address
- 5525 S Emerald Ave
Chicago, IL 60621-2953 - Phone
- (312) 636-3722
- NPI assigned
- Apr 8, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Taryrsha Davis, NURSE PRACTITIONER
- Title
- Nurse Practitioner
- Phone
- (312) 636-3722
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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Home Health Agency | 251E00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Clinic/Center | 261Q00000X | |||
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X |
Addresses
Primary practice location
5525 S Emerald Ave
Chicago, IL 60621-2953
Mailing address
5525 S Emerald Ave
Chicago, IL 60621-2953
Phone (312) 636-3722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
17504 E Carriageway Dr
Hazel Crest, IL 60429
Phone (773) 299-9299
343 N Wood Dale Rd
Ste 102
Wood Dale, IL 60191
Phone (773) 299-9299
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nurse Practitioner
- Naperville, IL
- NPI 1821552761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617840000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1649289600000",
"number": "1154901783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5525 S EMERALD AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606212953",
"telephone_number": "312-636-3722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5525 S EMERALD AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606212953",
"telephone_number": "312-636-3722"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AT YOUR DOOR PHYSICIAN CARE",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-08",
"last_updated": "2022-04-07",
"certification_date": "2022-04-07",
"status": "A",
"authorized_official_last_name": "DAVIS",
"authorized_official_first_name": "TARYRSHA",
"authorized_official_title_or_position": "NURSE PRACTITIONER",
"authorized_official_telephone_number": "312-636-3722",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "NURSE PRACTITIONER"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
}
],
"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 Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.