Organization Active NPI

Hyde Park Associates in Medicine LTD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1710092473
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HYDE PARK ASSOCIATES IN MEDICINE LTD
Practice address
1515 E 52ND PL
3Rd Floor
Chicago, IL 60615-4390
Phone
(773) 493-8212
Fax
(773) 955-2166
NPI assigned
Aug 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Stephanie Weaver, M.D.NPI 1942316229
Title
Physician Manager
Phone
(773) 493-8212

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 Physician 207R00000X NU Primary

Addresses

Primary practice location

1515 E 52ND PL
3Rd Floor
Chicago, IL 60615-4390

Mailing address

1515 E 52ND PL
3Rd Floor
Chicago, IL 60615-4390
Phone (773) 493-8212

Other identifiers 3

IdentifierTypeStateIssuer
0005485045OtherAETNA
0001616367OtherILBLUE CROSS BLUE SHIELD
CF1260OtherRR MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710092473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E 52ND PL",
            "address_2": "3RD FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154390",
            "telephone_number": "773-493-8212",
            "fax_number": "773-955-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E 52ND PL",
            "address_2": "3RD FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154390",
            "telephone_number": "773-493-8212",
            "fax_number": "773-955-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK ASSOCIATES IN MEDICINE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PHYSICIAN MANAGER",
        "authorized_official_telephone_number": "773-493-8212",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005485045",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001616367",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CF1260",
            "state": null
        }
    ],
    "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 Aug 22, 2020; 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.