NPIMap

Organization Active NPI

Circle Family Care

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1386707743
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CIRCLE FAMILY CARE
Practice address
5120 W Jackson
Chicago, IL 60644-4332
Phone
(773) 378-3900
Fax
(773) 378-2602
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Reuben J Pettiford
Title
Chief Executive Officer
Phone
(773) 379-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X IL Primary

Addresses

Primary practice location

5120 W Jackson
Chicago, IL 60644-4332

Mailing address

5002 W Madison
Chicago, IL 60644-4127
Phone (773) 379-1000

Other names 1

  • Community Health Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Circle Family Care14 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

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1386707743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 W MADISON",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606444127",
            "telephone_number": "773-379-1000",
            "fax_number": "773-379-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 W JACKSON",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606444332",
            "telephone_number": "773-378-3900",
            "fax_number": "773-378-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIRCLE FAMILY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PETTIFORD",
        "authorized_official_first_name": "REUBEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "773-379-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jul 21, 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.