Active NPI
Amit Phull, M.D.
- Emergency Medicine Physician
- Chicago, IL
National Provider Identifier
1346478096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 125-056164
- Practice address
- 645 N Michigan Ave
Suite 1058 a
Chicago, IL 60611-2826 - Phone
- (312) 926-2000
- NPI assigned
- Jul 1, 2009
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 125-056164 | IL | Primary |
Addresses
Primary practice location
645 N Michigan Ave
Suite 1058 a
Chicago, IL 60611-2826
Mailing address
259 E Erie St
Suite 100
Chicago, IL 60611-2930
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125-056164 | IL | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246406400000",
"number": "1346478096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 E ERIE ST",
"address_2": "SUITE 100",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "645 N MICHIGAN AVE",
"address_2": "SUITE 1058 A",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112826",
"telephone_number": "312-926-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHULL",
"first_name": "AMIT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-01",
"last_updated": "2009-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "125-056164",
"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 Jul 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.