NPIMap

Organization Active NPI

Medici Healthcare Providers S.C

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1336267467
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICI HEALTHCARE PROVIDERS S.C
Practice address
2381 N Milwaukee Ave
Chicago, IL 60647-2924
Phone
(773) 227-2687
Fax
(312) 288-0164
NPI assigned
Mar 27, 2007
Last updated
Dec 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Authorized official

Name
Dr. Mauricio Consalter, MDNPI 1083653927
Title
Ceo
Phone
(312) 550-2148

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

2381 N Milwaukee Ave
Chicago, IL 60647-2924

Mailing address

310 N Loomis St
Chicago, IL 60607-1147
Phone (312) 733-2273

Other practice location 1

355 W Dundee Rd Ste 110
Buffalo Grove, IL 60089-3500
Phone (847) 541-4878

National Provider Directory

National Provider Directory

Locations

2381 N Milwaukee Ave
Chicago, IL 60647
Phone (773) 227-2687

310 N Loomis St
Chicago, IL 60607
Phone (312) 243-8487

314 N Loomis St
Chicago, IL 60607
Phone (312) 733-2273

550 W Webster Ave
#1
Chicago, IL 60614
Phone (773) 883-1220

8741 S Greenwood Ave
#301
Chicago, IL 60619
Phone (773) 375-1300

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640131200000",
    "number": "1336267467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N LOOMIS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071147",
            "telephone_number": "312-733-2273",
            "fax_number": "312-733-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2381 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472924",
            "telephone_number": "773-227-2687",
            "fax_number": "312-288-0164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 W Dundee Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Buffalo Grove",
            "state": "IL",
            "postal_code": "600893500",
            "country_code": "US",
            "telephone_number": "847-541-4878",
            "fax_number": "847-520-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICI HEALTHCARE PROVIDERS S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A",
        "authorized_official_last_name": "CONSALTER",
        "authorized_official_first_name": "MAURICIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-550-2148",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.