Organization Active NPI

Caroline Nawara MD, S.C.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1699978379
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036081137 Issued in IL
Legal business name
CAROLINE NAWARA MD, S.C.
Practice address
401 S State St
Suite 430
Chicago, IL 60605-1229
Phone
(312) 789-4677
Fax
(312) 789-4676
NPI assigned
Jun 8, 2007
Last updated
Oct 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Authorized official

Name
Caroline Nawara, M.D.NPI 1851388995
Title
President
Phone
(312) 789-4677

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 036081137 IL Primary

Addresses

Primary practice location

401 S State St
Suite 430
Chicago, IL 60605-1229

Mailing address

401 S State St
Suite 430
Chicago, IL 60605-1229
Phone (312) 789-4677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041116001129 IL Part B Supplier - Clinic/Group Practice 0446214746 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

150 E Huron St
Ste 825
Chicago, IL 60611
Phone (312) 335-9155

30 N Michigan Ave
Ste 1218
Chicago, IL 60602
Phone (312) 789-4677

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1699978379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S STATE ST",
            "address_2": "SUITE 430",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051229",
            "telephone_number": "312-789-4677",
            "fax_number": "312-789-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S STATE ST",
            "address_2": "SUITE 430",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051229",
            "telephone_number": "312-789-4677",
            "fax_number": "312-789-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINE NAWARA MD, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "NAWARA",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-789-4677",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036081137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.