NPIMap

Organization Active NPI

Chicago Gastro LLC

  • Gastroenterology Physician
  • Chicago, IL
National Provider Identifier
1548414063
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CHICAGO GASTRO LLC
Practice address
945 W George St Ste 101
Chicago, IL 60657-5893
Phone
(773) 537-0020
NPI assigned
Nov 11, 2008
Last updated
Jan 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Authorized official

Name
Andrew Albert, M.D.NPI 1659413656
Title
Director
Phone
(773) 537-0020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X Primary

Addresses

Primary practice location

945 W George St Ste 101
Chicago, IL 60657-5893

Mailing address

PO Box 14763
Chicago, IL 60614-0763
Phone (773) 537-0020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090108000332 IL Part B Supplier - Clinic/Group Practice 5496818023 Receives reassigned benefits from 6 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

2835 N Sheffield Ave
Ste 303
Chicago, IL 60657
Phone (773) 368-3164

4546 N Marine Dr
Chicago, IL 60640

945 W George St
Ste 101
Chicago, IL 60657

3075 Highland Pkwy
Fl 6
Downers Grove, IL 60515
Phone (630) 929-5964

Practitioners & affiliated clinicians

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1548414063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14763",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606140763",
            "telephone_number": "773-537-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 W GEORGE ST STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575893",
            "telephone_number": "773-537-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO GASTRO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-11",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "ALBERT",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-537-0020",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "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 Jan 8, 2009; 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.