Organization Active NPI

Downers Grove Medical Group

  • Internal Medicine Physician
  • Downers Grove, IL
National Provider Identifier
1619150489
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-081176 Issued in IL
Legal business name
DOWNERS GROVE MEDICAL GROUP
Practice address
1034 Warren Ave
Downers Grove, IL 60515-3601
Phone
(630) 969-9200
NPI assigned
Dec 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Authorized official

Name
Dr. Sheela SwamyNPI 1831145416
Title
MD
Phone
(630) 969-9200

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036-081176 IL Primary

Addresses

Primary practice location

1034 Warren Ave
Downers Grove, IL 60515-3601

Mailing address

1121 Warren Ave Ste 200
Downers Grove, IL 60515-3572
Phone (630) 969-9200

Other identifiers 1

IdentifierTypeStateIssuer
CH6557OtherILRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110214000122 IL Part B Supplier - Clinic/Group Practice 9739369422 Receives reassigned benefits from 1 practitioner
Practice locations: Downers Grove, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1619150489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 WARREN AVE STE 200",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153572",
            "telephone_number": "630-969-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 WARREN AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153601",
            "telephone_number": "630-969-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNERS GROVE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "SWAMY",
        "authorized_official_first_name": "SHEELA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "630-969-9200",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-081176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH6557",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.