NPIMap

Organization Active NPI

Resilience Healthcare- Lakefront Medical Associates, LLC

Doing business as Chicago Health Medical Group

  • Family Medicine Physician
  • River Grove, IL
National Provider Identifier
1366915647
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RESILIENCE HEALTHCARE- LAKEFRONT MEDICAL ASSOCIATES, LLC
Doing business as
Chicago Health Medical Group
Practice address
8330 Grand Ave
River Grove, IL 60171-1435
Phone
(847) 451-0643
NPI assigned
Jan 9, 2019
Last updated
Dec 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Authorized official

Name
Manoj Prasad
Title
Ceo
Phone
(708) 763-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

8330 Grand Ave
River Grove, IL 60171-1435

Mailing address

4646 N Marine Dr
Chicago, IL 60640-5759

Other names 2

  • Chicago Health Medical Group Doing business as
  • CHMG - River Grove Other name

National Provider Directory

National Provider Directory
Tax ID family
Chicago Health Medical Group14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

8330 Grand Ave
River Grove, IL 60171
Phone (773) 564-6350

NPI Registry JSON

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672272000000",
    "number": "1366915647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8330 GRAND AVE",
            "city": "RIVER GROVE",
            "state": "IL",
            "postal_code": "601711435",
            "telephone_number": "847-451-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENCE HEALTHCARE- LAKEFRONT MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A",
        "authorized_official_last_name": "PRASAD",
        "authorized_official_first_name": "MANOJ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-763-6700"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chicago Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHMG - River Grove",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CHMG - River Grove",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in River Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; 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.