Poonam Pankaj Thaker, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

036-116808 Issued in IL

Practice address

7447 W Talcott Ave
Suite 182
Chicago, IL 60631-3745

Phone

(773) 792-5155

Fax

(773) 594-7975

NPI assigned

Apr 16, 2008

Last updated

Mar 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Family PracticeAlso: Physical Medicine and Rehabilitation

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Healthcare Illinois Medical Group LLCGroup PAC ID 5597275685, 278 clinicians

Presence Healthcare ServicesGroup PAC ID 2860396769, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117
• Presence Saint Joseph Hospital - Chicago Hospital, Chicago, IL, CCN 140224

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pthaker3500@ce-direct.presencehealth.org

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.

• Presence Healthcare Services

  dba Presence Medical Group

  • Multi-Specialty Clinic/Center
  • Elk Grove Village, IL
  • NPI 1932216819

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Prime Healthcare Illinois Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Des Plaines, IL
  • NPI 1023837689

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Presence Healthcare Services

  dba Presence Medical Group

  • Multi-Specialty Clinic/Center
  • Elk Grove Village, IL
  • NPI 1356727127
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Presence Chicago Hospitals Network

  dba Presence Saint Joseph Hospital-Chicago

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1679659585
  Care Compare affiliation
• Resurrection Medical Center - Chicago LLC

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1811735228
  Care Compare affiliation

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1508030057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE",
            "address_2": "SUITE 182",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-792-5155",
            "fax_number": "773-594-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE",
            "address_2": "SUITE 182",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-792-5155",
            "fax_number": "773-594-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKER",
        "first_name": "POONAM",
        "middle_name": "PANKAJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-116808",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036-116808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pthaker3500@ce-direct.presencehealth.org",
            "affiliation": "N",
            "address_1": "7447 W Talcott Ave",
            "address_2": "Suite 182",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606313745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cassandra Nhi Thai
• Tram Thai
• Sudip Dilip Thakar, MD
• Nisha Thaker, AU.D.
• Parth Thaker, MD
• Sarang Thaker, MD, MS
• Asmita Thakkar, PHARMD
• Dhaval B Thakkar, DMD
• Dhwanil Thakkar, M.D.
• Ghanshyam S. Thakkar, M.D.

• Sports Medicine (Family Medicine) Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Sports Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.