Individual provider Active NPI

Christine Clarice Zacharia, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Skokie, IL
National Provider Identifier
1376770081
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036135969 Issued in IL
Practice address
9977 Woods Dr Ste 300
Skokie, IL 60077-1057
Phone
(847) 663-8540
Fax
(847) 663-1015
NPI assigned
Jun 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125:056749 IL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036135969 IL Primary

Addresses

Primary practice location

9977 Woods Dr Ste 300
Skokie, IL 60077-1057

Mailing address

9977 Woods Dr Ste 300
Skokie, IL 60077-1057
Phone (847) 663-8540

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140910002007 IL Practitioner - EndocrinologyPractitioner - Internal Medicine 6800015579 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125:056749ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Aug 1, 2014 Accepting new patients
Endeavor Health Medical Group Family Medicine CurrentSince Mar 24, 2024 Accepting new patients
Rush University Medical Group Family Medicine CurrentSince Oct 1, 2018 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1725 W Harrison St
Ste 250
Chicago, IL 60612
Phone (312) 942-6163

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

9977 Woods Dr
Ste 120
Skokie, IL 60077
Phone (847) 663-8540

9977 Woods Dr
Ste 300
Skokie, IL 60077
Phone (847) 663-8508

Interoperability endpoints

  • Direct secure messaging: czacharia11937@direct.rush.rush-health.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1245456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1376770081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR STE 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "847-663-8540",
            "fax_number": "847-663-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR STE 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "847-663-8540",
            "fax_number": "847-663-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARIA",
        "first_name": "CHRISTINE",
        "middle_name": "CLARICE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-20",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125:056749",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036135969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.