Charles M Van Slambrouck, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

036132369 Issued in IL

Practice address

17800 Kedzie Ave
Hazel Crest, IL 60429-2029

Phone

(708) 799-8000

Fax

(708) 213-0163

NPI assigned

Jul 3, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Rush Medical College of Rush University, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Diagnostic Pathology, S.C.Group PAC ID 7911924428, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048
• Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
• Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288
• Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
• Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Midwest Diagnostic Pathology SC

  • Anatomic Pathology & Clinical Pathology Physician
  • Park Ridge, IL
  • NPI 1982606380
  Medicare reassignment Care Compare group NPD

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

• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Park Ridge, IL
  • NPI 1164539730
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Hazel Crest, IL
  • NPI 1467560128
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Oak Lawn, IL
  • NPI 1548375082
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1558479212
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Downers Grove, IL
  • NPI 1578670543
  Care Compare affiliation
• Advocate North Side Health Network

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1912014564
  Care Compare affiliation

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

{
    "created_epoch": "1278115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1356653596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17800 KEDZIE AVE",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292029",
            "telephone_number": "708-213-3457",
            "fax_number": "708-213-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17800 KEDZIE AVE",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292029",
            "telephone_number": "708-799-8000",
            "fax_number": "708-213-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN SLAMBROUCK",
        "first_name": "CHARLES",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-03",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "IL",
            "license": "036132369",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036132369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cvanslambrouck283842@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17800 Kedzie Ave",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "17800 Kedzie Ave",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Clinton Underhille
• United Mental Health Organization of Illinois
• United Pain Services SC
• United Pain Surgicore SC
• Universal Medical Products
• Vantage Cancer Care - Illinois, S.C.
• Vantage Cancer Care Network of Illinois, S.C.
• Varsha Bhan MD SC
• Vascular Surgery and Interpretation S.C.
• Vertical Plus MRI of America, LLC

• Anatomic Pathology & Clinical Pathology Physician in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.