Charles Logan, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036155323 Issued in IL

Practice address

251 East Huron Street
Chicago, IL 60611

Phone

(312) 227-4000

NPI assigned

Mar 20, 2018

Last updated

Jan 17, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1760986194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 EAST HURON STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-227-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 EAST HURON STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-227-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2750 West North Avenue",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60647",
            "country_code": "US",
            "telephone_number": "312-666-3494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1475 E Belvidere Road",
            "address_purpose": "LOCATION",
            "city": "Grayslake",
            "state": "IL",
            "postal_code": "60030",
            "country_code": "US",
            "telephone_number": "847-535-7157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "355 East Erie Street",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "312-238-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 East Chicago Avenue",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "312-227-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-20",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036155323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Square MRI
• Logan Square Supportive Living LLC
• Logan Square Surgery Center
• Logan Square Surgery Center Corp
• Logan Square Urgent Care Center Corporation
• Jennifer Rose Logan, LCSW
• Kelly Logan, M.D.
• Laura Ashley Logan, MSN, PMHNP-BC
• Lorretta G Logan
• Rebecca Lynn Logan

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.