Individual provider Active NPI

Erika Laraine Dayanghirang Chico, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1700308640
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125.069842 Issued in IL
Practice address
1501 S California Ave Ste L1026
Chicago, IL 60608-1732
Phone
(773) 202-5760
NPI assigned
Jul 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125.069842 IL Primary

Addresses

Primary practice location

1501 S California Ave Ste L1026
Chicago, IL 60608-1732

Mailing address

1501 S California Ave Ste L1026
Chicago, IL 60608-1732
Phone (773) 257-6097

Other identifiers 1

IdentifierTypeStateIssuer
125.069842OtherILTEMPORARY LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220810001391 CA Practitioner - Family Practice 1850718479 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.069842ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midtown Medical Corporation CurrentSince Jul 20, 2022 Accepting new patients
L.S.Olaes,M.D. a Medical Corporation CurrentSince Jul 20, 2022 Accepting new patients
Mount Sinai Hospital Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations

1267 N Virgil Ave
Los Angeles, CA 90029
Phone (323) 664-7628

1075 N Western Ave
Ste 110
Los Angeles, CA 90029
Phone (213) 861-8700

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24860/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1700308640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S CALIFORNIA AVE STE L1026",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081732",
            "telephone_number": "773-257-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S CALIFORNIA AVE STE L1026",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081732",
            "telephone_number": "773-202-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHICO",
        "first_name": "ERIKA LARAINE",
        "middle_name": "DAYANGHIRANG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.069842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEMPORARY LICENSE",
            "identifier": "125.069842",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.