Individual provider Active NPI

Kathya M Chartre, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1174831168
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.133054 Issued in IL
Practice address
4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone
(773) 388-1600
Fax
(773) 388-8936
NPI assigned
Sep 24, 2010
Last updated
Jan 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125.058223 IL
Family Medicine Physician 207Q00000X 036.133054 IL Primary

Addresses

Primary practice location

4025 N Sheridan Rd
Chicago, IL 60613-2010

Mailing address

121 W North Ave
Chicago, IL 60610-1315
Phone (312) 643-5606

Other practice location 1

121 W North Ave
Chicago, IL 60610-1315
Phone (312) 643-5606

Other identifiers 1

IdentifierTypeStateIssuer
036133054MedicaidIL

Other names 1

  • Kathya M Valdez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130812000082 IL Practitioner - Family Practice 2961644554 Reassigns benefits to 2 organizations
I20200322000005 IN Practitioner - Family Practice 2961644554 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.133054ILMDFamily Medicine Physician
125.058223ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presence Healthcare Services CurrentSince Oct 1, 2016 Accepting new patients
Presence Healthcare Services Family Medicine CurrentSince Oct 1, 2016 Accepting new patients
Howard Brown Health Center Current Accepting new patients
Howard Brown Health Center CurrentSince Dec 1, 2022 Accepting new patients
Howard Brown Health Center CurrentSince Dec 1, 2022 Accepting new patients
Presence Healthcare Services Family Medicine Current Accepting new patients
Pic Indiana PC CurrentSince Feb 4, 2020 Accepting new patients
Pic Wisconsin SC PastSince Sep 25, 2019 Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

2800 N Sheridan Rd
Ste 60
Chicago, IL 60657
Phone (773) 525-8846

4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800

62311 Collection Ctr Dr
Chicago, IL 60693

6500 N Clark St
Chicago, IL 60626
Phone (773) 681-5033

711 W North Ave
Fl 1
Chicago, IL 60610
Phone (312) 332-1982

924 W Pike St
Goshen, IN 46526
Phone (574) 312-7056

505 W Cleveland Rd
Mishawaka, IN 46545
Phone (574) 235-3135

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1174831168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101315",
            "telephone_number": "312-643-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132010",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-8936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606101315",
            "country_code": "US",
            "telephone_number": "312-643-5606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARTRE",
        "first_name": "KATHYA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-24",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.058223",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.133054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036133054",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHYA",
            "last_name": "VALDEZ",
            "middle_name": "M",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.