Terrence John Conway, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

03605824 Issued in IL

Practice address

1901 W Harrison St
Chicago, IL 60612-3714

Phone

(312) 864-6000

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Intercare Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Bangor, MI
  • NPI 1326058512
  NPD
• Intercare Community Health Network

  dba InterCare Child and Adolescent Behavioral Health Center

  • Federally Qualified Health Center (FQHC)
  • Eau Claire, MI
  • NPI 1336701119
  NPD

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851310122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2133 W CORTEZ ST",
            "address_2": "#2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223602",
            "telephone_number": "773-276-5249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "TERRENCE",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "03605824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "03655824",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keith Conway, MA
• Kelly Lyn Conway, M.S., CCC-SLP
• Lisa Annette Conway, PHD
• Samantha Danielle Conway, LCSW
• Shannon Julia Conway, MD
• Kathleen Susan Conwell, DPT, PT, ATC
• Christopher L Coogan, M.D.
• Kathleen Coogan
• Cook County (Fantus Health Center Pharmacy)
• Cook County (Cook County Health - S - UA)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.