Humboldt Park Health

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HUMBOLDT PARK HEALTH

Practice address

1044 N Francisco Ave
Chicago, IL 60622

Phone

(773) 292-8200

Fax

(773) 278-3899

NPI assigned

Jun 12, 2009

Organization subpart

No

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

Authorized official

Name

Dorothy Cheryl Erins

Title

Credentialing Specialist

Phone

(269) 244-5256

Specialties & licenses 8

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, VI, AZ, CO, TX, PR, SC, MA, NJ, PA, TN, WA, CA, NY, OH, MO, FL, MI, KS, NM, WI21 enrollments

Enrollment records 21

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Humboldt Park Health

  • Psychiatric Hospital Unit
  • Chicago, IL
  • NPI 1013944479

  8921907072

  Same PAC ID
• Humboldt Park Health

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1972594877

  8921907072

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Humboldt Park Health

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1972594877

  O20040107000704

  Same enrollment

Locations

Practitioners 194

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joel R Anderson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chicago, IL
  • NPI 1952341505

  IL, Podiatrist

  Medicare reassignment Care Compare group NPD
• Saeed Arefanian, MD

  • Surgery Physician
  • Chicago, IL
  • NPI 1821441643

  IL, Surgery

  Medicare reassignment Care Compare group NPD
• Ramon Barajas, MD

  • Obstetrics & Gynecology Physician
  • Chicago, IL
  • NPI 1477702611

  IL, Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Michael Joseph Benanti, DO

  • Diagnostic Radiology Physician
  • Rockford, IL
  • NPI 1619945342

  IL, NY

  Medicare reassignment Care Compare group NPD
• Yaimet Vidal Bucknor, MD

  • Hospitalist Physician
  • Belleville, IL
  • NPI 1902030836

  IL, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Ashley Marie Caleel, D.O.

  • Diagnostic Radiology Physician
  • Grayslake, IL
  • NPI 1578714044

  IL

  Medicare reassignment Care Compare group NPD
• Dagoberto Camacho, M.D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1629201512

  Family Medicine, IL

  Medicare reassignment Care Compare group NPD
• James Chatham Jr., M.D.

  • Diagnostic Radiology Physician
  • Rockford, IL
  • NPI 1629130141

  FL, IL

  Medicare reassignment Care Compare group NPD
• David C Chua, MD

  • Gastroenterology Physician
  • Oakbrook Terrace, IL
  • NPI 1346241585

  IL

  Medicare reassignment Care Compare group NPD
• Tyla Courtney

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1841329489

  IL, Internal Medicine

  Medicare reassignment Care Compare group NPD
• George R Cybulski, MD

  • Neurological Surgery Physician
  • Chicago, IL
  • NPI 1336107937

  IL

  Medicare reassignment Care Compare group NPD
• Charles M Davis, M.D.

  • Diagnostic Radiology Physician
  • Rockford, IL
  • NPI 1447240171

  IL, SC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1740417153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 N FRANCISCO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222743",
            "telephone_number": "773-292-8200",
            "fax_number": "773-278-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 N FRANCISCO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60622",
            "telephone_number": "773-292-8200",
            "fax_number": "773-278-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBOLDT PARK HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-12",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "ERINS",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "CHERYL",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "269-244-5256"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Chicago",
            "affiliation": "N",
            "address_1": "1044 N Francisco Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Humboldt Park Counseling, PLLC
• Humboldt Park Health
• Humboldt Park Health
• Humboldt Park Health
• Humboldt Park Health
• Humboldt Park Health
• Humboldt Park Health Emergency Medicine, LLC
• Humboldt Park Health Wellness Center Rehab Clinic
• Hillary Humer, M.S., CCC-SLP
• Charles Humes

• All providers in Chicago, IL
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.