Individual provider Active NPI

Fernando Soler, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1164582680
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36082596 Issued in IL
Practice address
2110 W Division St
Chicago, IL 60622-7272
Phone
(773) 235-7455
Fax
(773) 235-7055
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36082596 IL Primary

Addresses

Primary practice location

2110 W Division St
Chicago, IL 60622-7272

Mailing address

2110 W Division St
Chicago, IL 60622-7272
Phone (773) 235-7455

Other identifiers 1

IdentifierTypeStateIssuer
36082596OtherILSTATE LICENSE NUMBER

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
I20041117000022 IL Practitioner - Internal Medicine 3678537909 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36082596ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Care North Chicago LLC CurrentSince Nov 11, 2015 Accepting new patients
Preferred Physician Medical Group,LTD Internal Medicine Past Accepting new patients
Fastrac Medical, P.C. Past Accepting new patients
Presence Healthcare Services Past Accepting new patients
Rand Imaging Center Past Accepting new patients
San Pablo Medical Center, LTD. Internal Medicine Past Accepting new patients

Locations

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

750 Essington Rd
Joliet, IL 60435
Phone (815) 729-2160

4900 N Cumberland Ave
Norridge, IL 60706
Phone (312) 456-1600

205 S Northwest Hwy
Ste 120
Park Ridge, IL 60068
Phone (847) 292-5200

3475 S Alpine Rd
Rockford, IL 61109
Phone (815) 874-8000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1164582680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606227272",
            "telephone_number": "773-235-7455",
            "fax_number": "773-235-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606227272",
            "telephone_number": "773-235-7455",
            "fax_number": "773-235-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLER",
        "first_name": "FERNANDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36082596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "36082596",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.