Rogers Park Family Medicine, SC.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036096295 Issued in IL

Legal business name

ROGERS PARK FAMILY MEDICINE, SC.

Practice address

2306 W Touhy Ave # C1
Chicago, IL 60645-3414

Phone

(773) 262-7000

Fax

(773) 262-7002

NPI assigned

Aug 31, 2006

Last updated

Oct 10, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James P Clancy, MDNPI 1538162102

Title

President

Phone

(773) 262-7000

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• James P Clancy, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1538162102
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412899200000",
    "number": "1740391549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 W TOUHY AVE STE C1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606453473",
            "telephone_number": "773-262-7000",
            "fax_number": "773-262-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 W TOUHY AVE # C1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606453414",
            "telephone_number": "773-262-7000",
            "fax_number": "773-262-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGERS PARK FAMILY MEDICINE, SC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-10-10",
        "status": "A",
        "authorized_official_last_name": "CLANCY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-262-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036096295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER ID",
            "identifier": "214060",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01636575",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096295",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tavierney Rogan, RD
• Seth Roge
• Rogelio Liboon MD SC
• Rogelio O Cave MD SC
• Camille A Rogell, APRN, CNS
• Rogers Park One Day Surgery Center, Inc (Rogers Park Surgery Center)
• Rogers Park One Day Surgery Center, Inc (Herron Medical Center, LTD)
• Alexa Rogers
• Alicia Rogers, LCSW
• Angela D Rogers, FNP, MSN

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.