Organization Active NPI

Women'S Health Care Center of Chicago, S.C.

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1427336726
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
WOMEN'S HEALTH CARE CENTER OF CHICAGO, S.C.
Practice address
4009 W Fullerton Ave
Chicago, IL 60639-2103
Phone
(630) 415-6996
Fax
(888) 289-5746
NPI assigned
Aug 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Authorized official

Name
Adeeb Alshahrour, MDNPI 1225047921
Title
President
Phone
(773) 661-9049

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

4009 W Fullerton Ave
Chicago, IL 60639-2103

Mailing address

4009 W Fullerton Ave
Chicago, IL 60639-2103
Phone (630) 415-6996

Other identifiers 1

IdentifierTypeStateIssuer
036112499MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111017000649 IL Part B Supplier - Clinic/Group Practice 7214109271 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2032872Women'S Health Care Center of Chicago4009 W Fullerton Ave, Chicago, IL 60639ComplianceJan 10, 2028

National Provider Directory

National Provider Directory

Locations

4009 W Fullerton Ave
Chicago, IL 60639
Phone (773) 276-3333

4335 W Fullerton Ave
Chicago, IL 60639
Phone (773) 661-9049

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6561/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1427336726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392103",
            "telephone_number": "630-415-6996",
            "fax_number": "888-289-5746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392103",
            "telephone_number": "630-415-6996",
            "fax_number": "888-289-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMEN'S HEALTH CARE CENTER OF CHICAGO, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-03",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "ALSHAHROUR",
        "authorized_official_first_name": "ADEEB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-661-9049",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112499",
            "state": "IL"
        }
    ],
    "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 Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.