Chicagoland Integrated Professionals, Inc
Organization Active NPI Family Medicine Physician · Westchester, IL
NPI 1649688409 · NPPES record last updated Sep 17, 2019
Key facts
- NPI
- 1649688409
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CHICAGOLAND INTEGRATED PROFESSIONALS, INC
- Practice address
- 1132 Manchester Ave
Westchester, IL 60154-2723 - Phone
- (219) 934-5300
- Fax
- (219) 934-5389
- NPI assigned
- Jul 24, 2014
- Organization subpart
- No
Authorized official
- Name
- Ushma Sharma
- Title
- President
- Phone
- (217) 553-5936
Practitioners 4
-
Sagun Gautam, MD
-
Jennifer A Kubelka, FNP
-
Raquel Lyn Szarfinski, FNP-C
-
Chinnu Varkey, APN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141209001166 | IL | Part B Supplier - Clinic/Group Practice | 8022330745 |
Receives reassigned benefits from 4 practitioners Practice locations: Berwyn, IL; Chicago, IL; Cicero, IL; La Grange Park, IL; Melrose Park, IL; Northlake, IL; Willowbrook, IL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1132 Manchester Ave
Westchester, IL 60154-2723
Mailing address
534 Plainfield Rd
Willowbrook, IL 60527-5342
Phone (217) 553-5766
Other names
- Chicagoland Integrated Professionals,Inc
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All providers in Westchester, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.