NPIMap

Individual provider Active NPI

Magda Marie Houlberg, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1497925861
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036117896 Issued in IL
Practice address
6500 N Clark St
Chicago, IL 60626-4097
Phone
(773) 388-1600
Fax
(872) 269-3502
NPI assigned
Mar 2, 2008
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036117896 IL Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036117896 IL

Addresses

Primary practice location

6500 N Clark St
Chicago, IL 60626-4097

Mailing address

4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone (773) 388-1600

Other practice location 1

1525 E 55th St Ste 201
Chicago, IL 60615-5582
Phone (773) 388-1600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080829000090 IL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 0244306165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Rush Medical College of Rush University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Howard Brown Health CenterGroup PAC ID 1052203155, 52 clinicians

Practice addresses (Care Compare)

4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone (773) 388-1600

6500 N Clark St
Chicago, IL 60626-4002
Phone (773) 388-1600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Brown Health Center Current Accepting new patients
Howard Brown Health Center CurrentSince Mar 6, 2009 Accepting new patients
Howard Brown Health Center CurrentSince Mar 6, 2009 Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

1525 E 55th St
Ste 201
Chicago, IL 60615

4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800

6500 N Clark St
Chicago, IL 60626
Phone (773) 681-5033

Ownership & related parties

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Howard Brown Health CenterChicago, IL, CCN 141101 Federally qualified health center Corporate Officer
Operational/Managerial Control		 Oct 1, 2012
Jan 19, 2011
Howard Brown Health CenterChicago, IL, CCN 141108 Federally qualified health center Corporate Director Apr 1, 2014
Howard Brown Health Broadway Youth CenterChicago, IL, CCN 781807 Federally qualified health center Corporate Officer
Corporate Director
W-2 Managing Employee		 Oct 1, 2012
Oct 1, 2012
Oct 1, 2012
Howard Brown Health CenterChicago, IL, CCN 781844 Federally qualified health center Corporate Director Oct 1, 2012
Howard Brown Health 63Rd StreetChicago, IL, CCN 781857 Federally qualified health center Corporate Officer Feb 10, 2022
Howard Brown Health 55TH StChicago, IL, CCN 781877 Federally qualified health center Corporate Officer
Corporate Director
W-2 Managing Employee		 Feb 10, 2022
Oct 1, 2012
Oct 1, 2012
Howard Brown Health at TpanChicago, IL, CCN 781888 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Feb 10, 2022
Oct 1, 2012
Howard Brown Health DiverseyChicago, IL, CCN 781894 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Jan 30, 2017
Feb 10, 2022
Howard Brown Health at Thresholds SouthChicago, IL, CCN 781896 Federally qualified health center Corporate Officer Jan 30, 2017
Howard Brown Health CenterChicago, IL, CCN C41061 Federally qualified health center Corporate Director
W-2 Managing Employee		 May 15, 2012
May 15, 2012

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 5

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": "1204416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1497925861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132010",
            "telephone_number": "773-388-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606264097",
            "telephone_number": "773-388-1600",
            "fax_number": "872-269-3502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 E 55th St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606155582",
            "country_code": "US",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-8936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOULBERG",
        "first_name": "MAGDA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-02",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036117896",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036117896",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.