Active NPI
Edmund Chow, M.D.
- Dermatology Physician
- Flossmoor, IL
National Provider Identifier
1265483390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 036069361
- Practice address
- 1621 Tina LN
Flossmoor, IL 60422-1952 - Phone
- (708) 957-8753
- NPI assigned
- May 13, 2006
- Last updated
- Feb 4, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 036069361 | IL | Primary |
Addresses
Primary practice location
1621 Tina LN
Flossmoor, IL 60422-1952
Mailing address
1621 Tina LN
Flossmoor, IL 60422-1952
Phone (708) 957-8753
Other practice location 1
333 Dixie Hwy
Chicago Hts, IL 60411-1748
Phone (708) 756-0100
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | echow5954@Direct.FranciscanAlliance.org | Direct |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070410000245 | IL | Practitioner - Dermatology | 7911002514 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- echow5954@direct.franciscanalliance.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738627200000",
"number": "1265483390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1621 TINA LN",
"city": "FLOSSMOOR",
"state": "IL",
"postal_code": "604221952",
"telephone_number": "708-957-8753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1621 TINA LN",
"city": "FLOSSMOOR",
"state": "IL",
"postal_code": "604221952",
"telephone_number": "708-957-8753"
}
],
"practiceLocations": [
{
"address_1": "333 Dixie Hwy",
"address_purpose": "LOCATION",
"city": "Chicago Hts",
"state": "IL",
"postal_code": "604111748",
"country_code": "US",
"telephone_number": "708-756-0100",
"fax_number": "708-709-6353",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHOW",
"first_name": "EDMUND",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-13",
"last_updated": "2025-02-04",
"certification_date": "2025-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IL",
"license": "036069361",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "echow5954@Direct.FranciscanAlliance.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "3700 W 203rd St Ste 204",
"city": "Olympia Fields",
"state": "IL",
"country_code": "US",
"postal_code": "604611182",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Flossmoor, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.