Individual provider Active NPI

Anouar Teriaky, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1730587080
Registry record updated Dec 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036135524 Issued in IL
Practice address
5841 S Maryland Ave RM M421
Chicago, IL 60637-1447
Phone
(773) 702-8106
NPI assigned
Dec 17, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036135524 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave RM M421
Chicago, IL 60637-1447

Mailing address

5841 S Maryland Ave RM M421
Chicago, IL 60637-1447
Phone (773) 702-8106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036135524ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1418774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418774400000",
    "number": "1730587080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE RM M421",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-702-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE RM M421",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-702-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERIAKY",
        "first_name": "ANOUAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-17",
        "last_updated": "2014-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036135524",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 17, 2014; 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.