Individual provider Active NPI

Ivy Abraham

  • Hematology & Oncology Physician
  • Chicago, IL
National Provider Identifier
1497172845
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036142924 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Mar 24, 2014
Last updated
Jul 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hematology & Oncology Physician 207RH0003X 036142924 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

833 W 15TH PL
Chicago, IL 60608-1849

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201008002701 IL Practitioner - Hematology/Oncology 3870803679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ucm Medical Group Sub LLCGroup PAC ID 4688635337, 101 clinicians

Practice addresses (Care Compare)

1 Ingalls Dr
Harvey, IL 60426-3558
Phone (708) 333-2300

1600 Torrence Ave
Calumet City, IL 60409-5430
Phone (708) 647-7565

19550 Governors Hwy
Flossmoor, IL 60422-2147
Phone (708) 342-3000

71 W 156TH St
Harvey, IL 60426-4265

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ucm Medical Group Sub, LLC Hematology & Oncology CurrentSince Aug 24, 2020 Accepting new patients
Monroe Medical Associates, SC Hematology & Oncology Past Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

27702 Network Pl
Chicago, IL 60673

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

6701 159th St
#1
Tinley Park, IL 60477
Phone (708) 444-2226

6701 159th St
Ste 1
Tinley Park, IL 60477
Phone (708) 444-2226

Interoperability endpoints

  • Direct secure messaging: iabraham202160@uchospital.direct-ci.com

Organizations & group practices 2

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 3

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": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1497172845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 W 15TH PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "IVY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036142924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.