Chicago Medical Center Limited

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036070641 Issued in IL

Legal business name

CHICAGO MEDICAL CENTER LIMITED

Practice address

3650 W Armitage Ave
Chicago, IL 60647-3611

Phone

(773) 772-5111

Fax

(773) 772-5114

NPI assigned

Jul 27, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Yongsoo Kwon, M.D.

Title

President

Phone

(773) 772-5111

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1457736928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 W ARMITAGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473611",
            "telephone_number": "773-772-5111",
            "fax_number": "773-772-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 W ARMITAGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473611",
            "telephone_number": "773-772-5111",
            "fax_number": "773-772-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO MEDICAL CENTER LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-27",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "YONGSOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-772-5111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036070641",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036120995",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036070641",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Chicago, IL
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.