Chicagoland Physician Consortium, LLC

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

Legal business name

CHICAGOLAND PHYSICIAN CONSORTIUM, LLC

Practice address

3510 W 79TH St
Chicago, IL 60652-1430

Phone

(773) 459-9661

Fax

(312) 631-2892

NPI assigned

Sep 23, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Rudyard U Smith, M.D.

Title

Medical Director

Phone

(773) 459-9661

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504742400000",
    "number": "1720537384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 W 79TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606521430",
            "telephone_number": "773-459-9661",
            "fax_number": "312-631-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 W 79TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606521430",
            "telephone_number": "773-459-9661",
            "fax_number": "312-631-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGOLAND PHYSICIAN CONSORTIUM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-23",
        "last_updated": "2017-09-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "RUDYARD",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "773-459-9661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hospitalist Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Hospitalist Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; 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.