Juan Campbell, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-109131 Issued in IL

Practice address

2720 W 15TH St
1St Floor
Chicago, IL 60608-1610

Phone

(773) 257-1700

Fax

(773) 257-6888

NPI assigned

Aug 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11903/brand/1/csg/1/fhir/r4
• Direct secure messaging: juan.campbell.1@11903.direct.athenahealth.com

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.

• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1124187125
  Medicare reassignment NPD
• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1407458946
  NPD
• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1659127199
  NPD
• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1265114623
  NPD (past)
• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1316793813
  NPD (past)
• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1477812030
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336262400000",
    "number": "1205940582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 W 15TH ST",
            "address_2": "1ST FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081610",
            "telephone_number": "773-257-1700",
            "fax_number": "773-257-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 W 15TH ST",
            "address_2": "1ST FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081610",
            "telephone_number": "773-257-1700",
            "fax_number": "773-257-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JUAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2012-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-109131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Brian Campbell, PT, DPT, CSCS
• Jessica Campbell, LSW
• Jessica Campbell
• Jessica Lynn Campbell, M.A., CF-SLP
• Jolly Campbell, RN
• Karael Kaprice Campbell
• Kellie Hunter Campbell, M.D.
• Kristine M Campbell, FNP-BC
• Laura Campbell, PT
• Laura Antonese Campbell, MD

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.