Individual provider Active NPI

Adelis R Arias Jimenez, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1558833202
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.177721 Issued in IL
Practice address
4417 W Diversey Ave
Chicago, IL 60639-1923
Phone
(773) 377-7736
Fax
(815) 642-5723
NPI assigned
Dec 19, 2018
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.177721 IL Primary

Addresses

Primary practice location

4417 W Diversey Ave
Chicago, IL 60639-1923

Mailing address

PO Box 746715
Atlanta, GA 30374-6715
Phone (773) 377-7736

Other practice location 1

1819 N Harlem Ave
Chicago, IL 60707-3716
Phone (773) 589-4385

Other practice location 2

4848 W Irving Park Rd
Chicago, IL 60641-2718
Phone (773) 724-6200

Other names 1

  • Adelis Rafael Jimenez Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230703001534 IL Order and Referring Only - Family PracticePractitioner - Family Practice 6901265305

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Atlanta, GA 30374

PO Box
Suite 746715
Atlanta, GA 30374-6715

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.177721ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group, PC CurrentSince Aug 3, 2026 Accepting new patients
JW Plastic Surgery PLLC Past Accepting new patients
JW Operatory Past Accepting new patients

Locations

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

Organizations & group practices 3

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 1

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": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1558833202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746715",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746715",
            "telephone_number": "773-377-7736",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391923",
            "telephone_number": "773-377-7736",
            "fax_number": "815-642-5723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1819 N Harlem Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "607073716",
            "country_code": "US",
            "telephone_number": "773-589-4385",
            "fax_number": "872-228-8601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4848 W Irving Park Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606412718",
            "country_code": "US",
            "telephone_number": "773-724-6200",
            "fax_number": "773-866-8015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARIAS JIMENEZ",
        "first_name": "ADELIS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-19",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.177721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADELIS",
            "last_name": "JIMENEZ",
            "middle_name": "RAFAEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.