P. de Silva, M.D.., S.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036042344 Issued in IL

Legal business name

P. DE SILVA, M.D.., S.C.

Practice address

4248 W 63Rd St
Chicago, IL 60629-5037

Phone

(773) 585-4900

Fax

(773) 585-7262

NPI assigned

Apr 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Parakrama De Silva, M.D.

Title

President, P. de Silva, M.D., S.C.

Phone

(773) 585-4900

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280793600000",
    "number": "1629033774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4248 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295037",
            "telephone_number": "773-585-4900",
            "fax_number": "773-585-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4248 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295037",
            "telephone_number": "773-585-4900",
            "fax_number": "773-585-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P. DE SILVA, M.D.., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2010-08-03",
        "status": "A",
        "authorized_official_last_name": "DE SILVA",
        "authorized_official_first_name": "PARAKRAMA",
        "authorized_official_title_or_position": "PRESIDENT, P. DE SILVA, M.D., S.C.",
        "authorized_official_telephone_number": "773-585-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036042344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036042344",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "21601914",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "(RAILROAD) MEDICARE",
            "identifier": "062528037",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.