Active NPI
Fri Awasum, MD
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1417367814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036157802
- Practice address
- 2734 W 87TH St
Chicago, IL 60652-3937 - Phone
- (773) 918-4700
- NPI assigned
- May 7, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 036157802 | IL | Primary |
Addresses
Primary practice location
2734 W 87TH St
Chicago, IL 60652-3937
Mailing address
1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (773) 918-4700
Other practice location 1
2041 Georgia Ave NW Faclty Practice Plan Suite 3200
Washington, DC 20060-7232
Phone (202) 865-3200
Other practice location 2
1740 W Taylor St
Chicago, IL 60612-7232
Phone (866) 600-2273
Other practice location 3
1740 W Taylor St
Chicago, IL 60612-7232
Phone (866) 600-2273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036157802 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632873600000",
"number": "1417367814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1395 NW 167TH ST",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "331695710",
"telephone_number": "773-918-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2734 W 87TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606523937",
"telephone_number": "773-918-4700"
}
],
"practiceLocations": [
{
"address_1": "2041 Georgia Ave NW Faclty Practice Plan Suite 3200",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200607232",
"country_code": "US",
"telephone_number": "202-865-3200",
"fax_number": "202-865-3214",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1740 W Taylor St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606127232",
"country_code": "US",
"telephone_number": "866-600-2273",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1740 W Taylor St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606127232",
"country_code": "US",
"telephone_number": "866-600-2273",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AWASUM",
"first_name": "FRI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-07",
"last_updated": "2021-09-29",
"certification_date": "2021-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036157802",
"primary": true
}
],
"identifiers": [],
"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 Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.