Platinum Medical Associates, LTD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036130229 Issued in IL

Legal business name

PLATINUM MEDICAL ASSOCIATES, LTD

Practice address

2800 N Sheridan Rd
Suite 110
Chicago, IL 60657-6156

Phone

(773) 742-3941

NPI assigned

Jan 29, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Chris Tara Bulaon Delos Reyes, M.D.

Title

President

Phone

(773) 742-3941

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422489600000",
    "number": "1215327101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W ALTA RD",
            "address_2": "APT 3306",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N SHERIDAN RD",
            "address_2": "SUITE 110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576156",
            "telephone_number": "773-742-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM MEDICAL ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A",
        "authorized_official_last_name": "DELOS REYES",
        "authorized_official_first_name": "CHRIS TARA",
        "authorized_official_middle_name": "BULAON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-742-3941",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036130229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.