NPIMap

Individual provider Active NPI

Maggie E Chacko, MD

  • Internal Medicine Physician
  • Elmhurst, IL
National Provider Identifier
1417993734
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036098672 Issued in IL
Practice address
305 N. York Rd
Elmhurst, IL 60126
Phone
(331) 221-4350
Fax
(331) 221-3934
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036098672 IL Primary

Addresses

Primary practice location

305 N. York Rd
Elmhurst, IL 60126

Mailing address

4201 Winfield Rd FL 4
Warrenville, IL 60555-4025
Phone (331) 221-6377

Other practice location 1

429 N York St
Elmhurst, IL 60126-2003
Phone (331) 221-4350

Other practice location 2

3005 Wolf Rd
Westchester, IL 60154-5622
Phone (331) 221-4390

Other identifiers 1

IdentifierTypeStateIssuer
036098672MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mchacko41727@direct.edward.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040617000221 IL Practitioner - Internal Medicine 1153304084 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

429 N York St
Elmhurst, IL 60126-2003
Phone (331) 221-9001

8 Salt Creek LN
Hinsdale, IL 60521-2903

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036098672ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Internal Medicine CurrentSince Dec 1, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 1, 2023 Accepting new patients
Elmhurst Memorial Healthcare CurrentSince Sep 1, 2010 Accepting new patients
Healthguard Medical Network SC Internal Medicine Past Accepting new patients
Wyse Eyecare SC Past Accepting new patients
Elmhurst Memorial Affiliated Primary Care Physicians, LLC Internal Medicine Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

429 N York St
Elmhurst, IL 60126
Phone (331) 221-4350

172 E Schiller St
Elmhurst, IL 60126
Phone (331) 221-6377

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

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

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

8 Salt Creek Ln
Fl 1
Hinsdale, IL 60521

701 W North Ave
Melrose Park, IL 60160
Phone (708) 450-5779

4201 Winfield Rd
Fl 4
Warrenville, IL 60555

3005 Wolf Rd
Westchester, IL 60154
Phone (331) 221-4390

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1417993734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 WINFIELD RD FL 4",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554025",
            "telephone_number": "331-221-6377",
            "fax_number": "331-221-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 N. YORK RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "60126",
            "telephone_number": "331-221-4350",
            "fax_number": "331-221-3934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "429 N York St",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "IL",
            "postal_code": "601262003",
            "country_code": "US",
            "telephone_number": "331-221-4350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3005 Wolf Rd",
            "address_purpose": "LOCATION",
            "city": "Westchester",
            "state": "IL",
            "postal_code": "601545622",
            "country_code": "US",
            "telephone_number": "331-221-4390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "MAGGIE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036098672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098672",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mchacko41727@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "429 N York St",
            "city": "Elmhurst",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601262003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.