Portage Park Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PORTAGE PARK MEDICAL GROUP

Practice address

3401 N Central Ave
Chicago, IL 60634-4426

Phone

(773) 286-8822

Fax

(773) 824-4997

NPI assigned

May 4, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard Ansfield

Title

Director

Phone

(773) 286-8822

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Kaplan, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1073561460
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184672966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344426",
            "telephone_number": "773-286-8822",
            "fax_number": "773-824-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344426",
            "telephone_number": "773-286-8822",
            "fax_number": "773-824-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE PARK MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANSFIELD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-286-8822"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS #",
            "identifier": "01635515",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ana Porta
• Emily Porta
• Nicolas FM Porta, MD
• Portage Park Dental Associates, LTD
• Portage Park Dental Studio
• Portage Park Satellite Senior Center
• Jasmin Portaz
• Alexander Jay Porte, M.D.
• Michael A Porte, MD
• Sara E Porte

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.