NPIMap

Organization Active NPI

Carlos H Zambrano MD LLC

  • Infectious Disease Physician
  • Chicago, IL
National Provider Identifier
1467477257
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
036098517 Issued in IL
Legal business name
CARLOS H ZAMBRANO MD LLC
Practice address
2434 W Division St
Chicago, IL 60622-2942
Phone
(773) 486-8820
Fax
(773) 486-8823
NPI assigned
Jul 13, 2006
Last updated
Aug 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Authorized official

Name
Carlos H Zambrano, MDNPI 1639139272
Title
MD/Director
Phone
(773) 486-8820

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
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X 036098517 IL Primary

Addresses

Primary practice location

2434 W Division St
Chicago, IL 60622-2942

Mailing address

PO Box 8088
Wilmette, IL 60091-8088
Phone (773) 486-8820

Other identifiers 3

IdentifierTypeStateIssuer
0001636111OtherILBLUE CROSS/BLUE SHIELD
615318701OtherILUS DEPARTMENT OF LABOR
615318700OtherILUS DEPARTMENT OF LABOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060329000167 IL Part B Supplier - Clinic/Group Practice 3779591003 Receives reassigned benefits from 3 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

2434 W Division St
Chicago, IL 60622
Phone (773) 486-8820

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440720000000",
    "number": "1467477257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8088",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600918088",
            "telephone_number": "773-486-8820",
            "fax_number": "773-486-8823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222942",
            "telephone_number": "773-486-8820",
            "fax_number": "773-486-8823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS H ZAMBRANO MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2015-08-28",
        "status": "A",
        "authorized_official_last_name": "ZAMBRANO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MD/DIRECTOR",
        "authorized_official_telephone_number": "773-486-8820",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036098517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0001636111",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "615318701",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "615318700",
            "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 Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.