Petham Muthuswamy, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

03604724 Issued in IL

Practice address

7531 South Stony Island
Suite 169
Chicago, IL 60649

Phone

(773) 947-7715

Fax

(773) 643-0175

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Specialty

Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine

Education

Other, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jackson Park Hospital Hospital, Chicago, IL, CCN 140177

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pethammuthuswamy@jph.medalliesdirect.net

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

• Petham Muthuswamy, M.D., SC

  • Clinic/Center
  • Chicago, IL
  • NPI 1801075429
  Medicare reassignment NPD Authorized official
• 1801075429

  • Pulmonary Disease Physician
  • Chicago, IL
  • NPI 1053293415
  NPD Authorized official
• Jackson Park Hospital Foundation

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1497750699
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jackson Park Hospital Foundation

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1497750699
  Care Compare affiliation

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1205922770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7531 SOUTH STONY ISLAND",
            "address_2": "SUITE 169",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60649",
            "telephone_number": "773-947-7715",
            "fax_number": "773-643-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7531 SOUTH STONY ISLAND",
            "address_2": "SUITE 169",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60649",
            "telephone_number": "773-947-7715",
            "fax_number": "773-643-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTHUSWAMY",
        "first_name": "PETHAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036047024",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "03604724",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "03604724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "202773",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "3048491",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0002201085",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "362993972",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCES",
            "identifier": "362993972",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRM",
            "identifier": "110017592",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SHARE",
            "identifier": "4880209",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "46K13",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036047024",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raja Kannan Mutharasan, MD
• Amisha Muthialu, PT, DPT
• Albin J Mutholam, PT, DPT
• Rachel Wangui Muthui, ANP
• Sriranjini Muthukrishnan, M.D.
• Ece Mutlu, M.D.
• Gokhan Mutlu
• Hemant Raj Mutneja, M.D.
• Saad Muttar, MD
• Jerry M Mutua, M.D.

• Pulmonary Disease Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pulmonary Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.