Chicago Monticello Medical Ctr

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

CHICAGO MONTICELLO MEDICAL CTR

Doing business as

Michael W Early MD

Practice address

3623 W Chicago Ave
Chicago, IL 60651-3934

Phone

(773) 722-6171

Fax

(773) 722-7913

NPI assigned

Jul 30, 2006

Last updated

Nov 19, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael EarleyNPI 1922107952

Title

MD

Phone

(773) 722-6171

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MICHAEL W EARLY MD Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael William Earley, M. D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1922107952
  Authorized official Same address or phone

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1447265053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3623 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606513934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3623 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606513934",
            "telephone_number": "773-722-6171",
            "fax_number": "773-722-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO MONTICELLO MEDICAL CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "EARLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "773-722-6171"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1478723",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "1478723",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICHAEL W EARLY MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Non-Pharmacy Dispensing Site in Chicago, IL
• Providers in Chicago, IL by specialty
• Non-Pharmacy Dispensing Site in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; 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.