Organization Active NPI

Greenview Health Center Chartered

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1184632051
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036061009 Issued in IL
Legal business name
GREENVIEW HEALTH CENTER CHARTERED
Practice address
5025 N Paulina Ave
Ste 101
Chicago, IL 60640-2772
Phone
(773) 334-9056
Fax
(773) 334-9009
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Authorized official

Name
Mr. Fernando Adalberto Ojea, MD
Title
Owner
Phone
(773) 334-9056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 036061009 IL Primary

Addresses

Primary practice location

5025 N Paulina Ave
Ste 101
Chicago, IL 60640-2772

Mailing address

PO Box 57120
Chicago, IL 60657-0120
Phone (773) 334-9056

Other identifiers 3

IdentifierTypeStateIssuer
010012601OtherILMED RR
036061009MedicaidIL
003160120OtherILBCBC

National Provider Directory

National Provider Directory

Locations

5025 N Paulina St
Ste 101
Chicago, IL 60640
Phone (773) 334-9056

4538 N Beacon St
Chicago, IL 60640
Phone (773) 275-7200

4646 N Marine Dr
#A
Chicago, IL 60640
Phone (217) 415-1831

Practitioners & affiliated clinicians

Practitioners 2

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": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1184632051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57120",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606570120",
            "telephone_number": "773-334-9056",
            "fax_number": "773-334-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 N PAULINA AVE",
            "address_2": "STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402772",
            "telephone_number": "773-334-9056",
            "fax_number": "773-334-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVIEW HEALTH CENTER CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "OJEA",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_middle_name": "ADALBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-334-9056",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036061009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED RR",
            "identifier": "010012601",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061009",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBC",
            "identifier": "003160120",
            "state": "IL"
        }
    ],
    "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 Aug 14, 2013; 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.