Organization Active NPI

Chicago Integrated Health

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
National Provider Identifier
1538697529
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
CHICAGO INTEGRATED HEALTH
Practice address
30 S Michigan Ave Ste 400
Chicago, IL 60603-3222
Phone
(312) 726-1353
Fax
(312) 726-5238
NPI assigned
Jun 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Anne Gordon, DC
Title
Owner
Phone
(312) 726-1353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

30 S Michigan Ave Ste 400
Chicago, IL 60603-3222

Mailing address

30 S Michigan Ave Ste 400
Chicago, IL 60603-3222
Phone (312) 726-1353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211223000528 IL Part B Supplier - Clinic/Group Practice 6800287004 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1538697529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S MICHIGAN AVE STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606033222",
            "telephone_number": "312-726-1353",
            "fax_number": "312-726-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S MICHIGAN AVE STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606033222",
            "telephone_number": "312-726-1353",
            "fax_number": "312-726-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO INTEGRATED HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-726-1353",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 21, 2022; 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.