Supreme MD Inc.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

SUPREME MD INC.

Practice address

5737 N Talman Ave Apt 2
Chicago, IL 60659-5097

Phone

(773) 329-6545

NPI assigned

Jan 20, 2021

Organization subpart

No

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

Authorized official

Name

Cesario Boligor

Title

Ceo

Phone

(773) 329-6545

Specialties & licenses 4

Addresses

Other names 1

• Supreme MD Doing business as

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611100800000",
    "number": "1366032724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5737 N TALMAN AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606595097",
            "telephone_number": "773-329-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5737 N TALMAN AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606595097",
            "telephone_number": "773-329-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A",
        "authorized_official_last_name": "BOLIGOR",
        "authorized_official_first_name": "CESARIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-329-6545"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Supreme MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Supported Independence
• Supportive Services Agency, LLC
• Supportive Steps to Recovery
• Suppported Independence
• Supreme Home Healthcare LLC
• Gaminee Patel Sura, OTR/L
• Harsh Rohitkumar Sura, M.B.B.S
• Divya Meher Surabhi, MD, MPH
• Nicholas Paul Suraci, M.D.
• Hussam Suradi, M.D.

• Geriatric Medicine (Family Medicine) Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Geriatric Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.