Suresh C Hathiwala, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Practice address

California Ave 15TH Street
Dept of Medicine
Chicago, IL 60608-1797

Phone

(773) 257-6552

Fax

(773) 257-6027

NPI assigned

Jul 5, 2005

Last updated

Sep 6, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1508863655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 N KENILWORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021237",
            "telephone_number": "708-383-6996",
            "fax_number": "773-257-6027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALIFORNIA AVE 15TH STREET",
            "address_2": "DEPT OF MEDICINE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081797",
            "telephone_number": "773-257-6552",
            "fax_number": "773-257-6027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHIWALA",
        "first_name": "SURESH",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "C30486",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1616108",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Hatchett, RN
• Tarsha Hatchett
• Danielle Hatchimonji, PHD
• Justin Hatchimonji
• David William Hatfield
• Hatipoglu Medical SC
• Jessica N Hatler, LMT
• Cameron Renee Hatlevig, CRNA
• Nawar Hatoum, MD
• Yousef A. Y. Hattab, MD

• Nephrology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.