Organization Active NPI

Erlinda B. Siwa M.D.; SC

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1710144944
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036048108 Issued in IL
Legal business name
ERLINDA B. SIWA M.D.; SC
Practice address
4254 W 55TH St
Chicago, IL 60632-4642
Phone
(773) 767-0606
Fax
(773) 767-1065
NPI assigned
May 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Authorized official

Name
Erlinda B Siwa, M.D.
Title
M.D.
Phone
(773) 767-0606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 036048108 IL Primary

Addresses

Primary practice location

4254 W 55TH St
Chicago, IL 60632-4642

Mailing address

4254 W 55TH St
Chicago, IL 60632-4642
Phone (773) 767-0606

Other identifiers 1

IdentifierTypeStateIssuer
036048108MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1710144944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4254 W 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324642",
            "telephone_number": "773-767-0606",
            "fax_number": "773-767-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4254 W 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324642",
            "telephone_number": "773-767-0606",
            "fax_number": "773-767-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERLINDA B. SIWA M.D.; SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "SIWA",
        "authorized_official_first_name": "ERLINDA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "773-767-0606",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036048108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036048108",
            "state": "IL"
        }
    ],
    "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 May 16, 2008; 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.