Individual provider Active NPI

Allan Manuel Taaca

  • Surgery Physician
  • Chicago, IL
National Provider Identifier
1255587770
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
125053965 Issued in IL
Practice address
1900 W Polk St., Admin Building 10TH Floor
John. H. Stroger Jr. Hospital of Cook County
Chicago, IL 60612
Phone
(312) 864-0065
NPI assigned
Aug 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 125053965 IL Primary

Addresses

Primary practice location

1900 W Polk St., Admin Building 10TH Floor
John. H. Stroger Jr. Hospital of Cook County
Chicago, IL 60612

Mailing address

7818 Del CT
Darien, IL 60561-4550

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
I20120802000600 GA Practitioner - Emergency Medicine 1052567237 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rush Medical College of Rush University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Georgia-TCG PCGroup PAC ID 8921492380, 39 clinicians

Practice addresses (Care Compare)

459 Hwy 119 S
Springfield, GA 31329-3021
Phone (912) 754-6451

Hospital & facility affiliations

  • Savannah Health Services LLC Dba Memorial Health University Medical Center Hospital, Savannah, GA, CCN 110036
  • Effingham Health System Hospital, Springfield, GA, CCN 111306

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125053965ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Emergency Physician Specialists CurrentSince Aug 1, 2012 Accepting new patients

Locations

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

459 Highway 119 S
Springfield, GA 31329
Phone (912) 754-0200

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1255587770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7818 DEL CT",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605614550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W POLK ST., ADMIN BUILDING 10TH FLOOR",
            "address_2": "JOHN. H. STROGER JR. HOSPITAL OF COOK COUNTY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-864-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAACA",
        "first_name": "ALLAN",
        "middle_name": "MANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125053965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.