Active NPI
Phillip Ahn, M.D.
- Family Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036089338
- Practice address
- 4321 S Pulaski Rd
Chicago, IL 60632-4008 - Phone
- (773) 585-2410
- Fax
- (773) 284-0913
- NPI assigned
- Nov 30, 2005
- Last updated
- Mar 29, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036089338 | IL | Primary |
Addresses
Primary practice location
4321 S Pulaski Rd
Chicago, IL 60632-4008
Mailing address
2525 S Michigan Ave
B-390
Chicago, IL 60616-2333
Phone (312) 567-6691
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01621679 | Other | IL | BCBS OF IL |
| 205737 | Other | IL | MEDICARE PTAN |
| 036089338 / 02 | Medicaid | IL |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (888) 824-0200
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The University of Chicago Medical Center | Current | Accepting new patients | |
| The University of Chicago Medical Center | Current | Accepting new patients | |
| University of Chicago | Current | Accepting new patients | |
| Edna Richard M D | Past | Accepting new patients |
Locations
150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061
2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153
2525 S Michigan Ave
#B390
Chicago, IL 60616
Phone (312) 567-6691
350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500
120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700
Interoperability endpoints
- pahn211712@uchospital.direct-ci.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1821048786
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1033218128
-
dba UCMC Pharmacy Services
- Community/Retail Pharmacy
- Calumet City, IL
- NPI 1255895678
-
- Gynecology Physician
- Chicago, IL
- NPI 1841405396
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1508956509
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459209600000",
"number": "1376527879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 S MICHIGAN AVE",
"address_2": "B-390",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606162333",
"telephone_number": "312-567-6691",
"fax_number": "312-328-7895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4321 S PULASKI RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606324008",
"telephone_number": "773-585-2410",
"fax_number": "773-284-0913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHN",
"first_name": "PHILLIP",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-30",
"last_updated": "2016-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036089338",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF IL",
"identifier": "01621679",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "205737",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036089338 / 02",
"state": "IL"
}
],
"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 Mar 29, 2016; 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.