NPIMap

Organization Active NPI

Resilience Healthcare - Lakefront Medical Associates, LLC

Doing business as Chicago Health Medical Group

  • Internal Medicine Physician
  • Oak Park, IL
National Provider Identifier
1720551096
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RESILIENCE HEALTHCARE - LAKEFRONT MEDICAL ASSOCIATES, LLC
Doing business as
Chicago Health Medical Group
Practice address
1 Erie CT Ste 7000
Oak Park, IL 60302-2567
Phone
(844) 533-2464
NPI assigned
Jan 9, 2019
Last updated
Jan 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Authorized official

Name
Manoj Prasad
Title
Ceo
Phone
(708) 763-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

1 Erie CT Ste 7000
Oak Park, IL 60302-2567

Mailing address

4646 N Marine Dr
Chicago, IL 60640-5759

Other names 2

  • Chicago Health Medical Group Doing business as
  • CHMG - Internal Medicine Other name

National Provider Directory

National Provider Directory
Tax ID family
Chicago Health Medical Group14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

1 Erie Ct
Ste 7000
Oak Park, IL 60302
Phone (708) 763-1701

NPI Registry JSON

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1720551096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ERIE CT STE 7000",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022567",
            "telephone_number": "844-533-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENCE HEALTHCARE - LAKEFRONT MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "PRASAD",
        "authorized_official_first_name": "MANOJ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-763-6700"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chicago Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHMG - Internal Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CHMG - Internal Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.