Commonwealth Medical Physician Group, S.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036061003 Issued in IL

Legal business name

COMMONWEALTH MEDICAL PHYSICIAN GROUP, S.C.

Practice address

2800 N. Sheridan Rd
#400
Chicago, IL 60657-6157

Phone

(773) 472-5803

Fax

(773) 472-7902

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Sharon Afable

Title

Practice Administrator

Phone

(773) 472-5803

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1194886754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N. SHERIDAN RD",
            "address_2": "#400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576157",
            "telephone_number": "773-472-5803",
            "fax_number": "773-472-7902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N. SHERIDAN RD",
            "address_2": "#400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576157",
            "telephone_number": "773-472-5803",
            "fax_number": "773-472-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH MEDICAL PHYSICIAN GROUP, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "AFABLE",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "773-472-5803",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036061003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Chicago, IL
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• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; 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.