Organization Active NPI

Collette Ara Honore MDSC

  • Dermatology Physician
  • Chicago, IL
National Provider Identifier
1841371184
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
COLLETTE ARA HONORE MDSC
Practice address
1525 E 55TH St
Chicago, IL 60615-5512
Phone
(773) 667-5577
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Collette Ara Honore, MDNPI 1174636930
Title
Dermatologist
Phone
(312) 404-1602

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X IL Primary

Addresses

Primary practice location

1525 E 55TH St
Chicago, IL 60615-5512

Mailing address

4938 S Washington Park CT
Chicago, IL 60615-2304

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050208000893 IL Part B Supplier - Clinic/Group Practice 1052362936 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841371184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4938 S WASHINGTON PARK CT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606152304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606155512",
            "telephone_number": "773-667-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLETTE ARA HONORE MDSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ARA HONORE",
        "authorized_official_first_name": "COLLETTE",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "312-404-1602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "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 Aug 22, 2020; 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.