Organization Active NPI

Independent Physicians' Aco of Chicago, LLC

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1174903512
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INDEPENDENT PHYSICIANS' ACO OF CHICAGO, LLC
Practice address
2740 W Foster Ave
Suite 116
Chicago, IL 60625-3500
Phone
(773) 989-6262
NPI assigned
Jun 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Authorized official

Name
Mr. John Venetos, MDNPI 1952324584
Title
President
Phone
(773) 989-6262

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X IL Primary

Addresses

Primary practice location

2740 W Foster Ave
Suite 116
Chicago, IL 60625-3500

Mailing address

2740 W Foster Ave
Suite 116
Chicago, IL 60625-3500
Phone (773) 989-6262

National Provider Directory

National Provider Directory

Locations

2740 W Foster Ave
Ste 116
Chicago, IL 60625
Phone (773) 989-6262

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433116800000",
    "number": "1174903512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE",
            "address_2": "SUITE 116",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253500",
            "telephone_number": "773-989-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE",
            "address_2": "SUITE 116",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253500",
            "telephone_number": "773-989-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT PHYSICIANS' ACO OF CHICAGO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A",
        "authorized_official_last_name": "VENETOS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-989-6262",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "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 1, 2015; 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.