Individual provider Active NPI

Pavil Thenamkodath Cherian, M.D.

  • Psychiatry Physician
  • Hines, IL
National Provider Identifier
1376627620
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Practice address
Edward Hines VA Hospital
Mental Health Service Line - BLG 228
Hines, IL 60141
Phone
(708) 202-7817
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X IL Primary

Addresses

Primary practice location

Edward Hines VA Hospital
Mental Health Service Line - BLG 228
Hines, IL 60141

Mailing address

2027 W Ohio St
Chicago, IL 60612-1515

Other names 1

  • Dr. Paul T. Cherian Jr. Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-112114ILMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376627620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2027 W OHIO ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EDWARD HINES VA HOSPITAL",
            "address_2": "MENTAL HEALTH SERVICE LINE - BLG 228",
            "city": "HINES",
            "state": "IL",
            "postal_code": "60141",
            "telephone_number": "708-202-7817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERIAN",
        "first_name": "PAVIL",
        "middle_name": "THENAMKODATH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "CHERIAN",
            "middle_name": "T.",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hines, IL

Sources for this page

Verify at the official NPI Registry.