NPIMap

Individual provider Active NPI

Michelle Chan, DO

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1629717293
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125080662 Issued in IL
Practice address
1901 W Harrison St
Chicago, IL 60612-3714
Phone
(312) 864-6000
NPI assigned
Jun 1, 2022
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 125080662 IL Primary

Addresses

Primary practice location

1901 W Harrison St
Chicago, IL 60612-3714

Mailing address

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 864-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251008000376 IL Practitioner - Internal Medicine 3173906625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Current Accepting new patients
Cook County Internal Medicine CurrentSince Sep 19, 2025 Accepting new patients
Cook County CurrentSince Sep 19, 2025 Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

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.

  • Cook County

    dba John H. Stroger, Jr. Hospital of Cook County

    • General Acute Care Hospital
    • Chicago, IL
    • NPI 1588612832
    Medicare reassignment Care Compare group NPD
  • Cook County

    dba Cook County Health & Hospitals System Physician Services

    • Emergency Medicine Physician
    • Chicago, IL
    • NPI 1821385170

    Internal Medicine

    NPD
  • Cook County

    dba Bronzeville Health Center

    • Multi-Specialty Clinic/Center
    • Chicago, IL
    • NPI 1831219450
    NPD

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1629717293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125080662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.