Individual provider Active NPI

Alfred Tawiah Solomon, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1215458104
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125070189 Issued in IL
Practice address
1901 W Harrison St
Chicago, IL 60612-3714
Phone
(312) 864-6000
NPI assigned
Jun 29, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125070189 IL Primary

Addresses

Primary practice location

1901 W Harrison St
Chicago, IL 60612-3714

Mailing address

828 S Leavitt St # a
Chicago, IL 60612-4210
Phone (312) 383-1312

Other practice location 1

1969 W Ogden Ave
Chicago, IL 60612-3765
Phone (312) 864-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20220606001744 GA Practitioner - NephrologyPractitioner - Internal Medicine 4183998917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oconee Medical GroupGroup PAC ID 2365497344, 3 clinicians

Practice addresses (Care Compare)

1440 N Chase St
Athens, GA 30601-1850
Phone (706) 227-2110

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12366GAMDGeneral Practice Dentistry
125070189ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oconee Medical Group CurrentSince Jul 6, 2022 Accepting new patients

Locations

1440 N Chase St
Athens, GA 30601
Phone (706) 227-2110

Organizations & group practices 1

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

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215458104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 S LEAVITT ST # A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124210",
            "telephone_number": "312-383-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1969 W Ogden Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123765",
            "country_code": "US",
            "telephone_number": "312-864-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "ALFRED",
        "middle_name": "TAWIAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125070189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.