Individual provider Active NPI

Tamara Amponsah

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1821871682
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125.082746 Issued in IL
Practice address
1750 W Harrison St
Chicago, IL 60612-3825
Phone
(312) 942-7802
Fax
(312) 942-4021
NPI assigned
Aug 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125.082746 IL Primary

Addresses

Primary practice location

1750 W Harrison St
Chicago, IL 60612-3825

Mailing address

1750 W Harrison St
Chicago, IL 60612-3825
Phone (312) 942-7802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20260611002188 NC Practitioner - Emergency Medicine 4183079775

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4535 Dressier Rd NW
Canton, OH 44718-2545

4535 Dressler Rd NW
Canton, OH 44718-2545

516 S Denvir Ave
Apt 2
Chicago, IL 60612-0279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125.082746ILMDEmergency Medicine Physician

Interoperability endpoints

  • Direct secure messaging: tamponsah408097@direct.myadvocateaurora.org

NPI Registry JSON

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1821871682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123825",
            "telephone_number": "312-942-7802",
            "fax_number": "312-942-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123825",
            "telephone_number": "312-942-7802",
            "fax_number": "312-942-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMPONSAH",
        "first_name": "TAMARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.082746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.