NPIMap

Organization Active NPI

Associated Medical Centers SC

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1851504161
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042004703 Issued in IL
Legal business name
ASSOCIATED MEDICAL CENTERS SC
Practice address
7531 So Stony Island
St 176
Chicago, IL 60649
Phone
(773) 947-7746
Fax
(773) 947-7751
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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

Authorized official

Name
Michael T Foreman, MDNPI 1922151117
Title
President
Phone
(773) 947-7746

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 042004703 IL Primary

Addresses

Primary practice location

7531 So Stony Island
St 176
Chicago, IL 60649

Mailing address

7531 So Stony Island
St 176
Chicago, IL 60649
Phone (773) 947-7746

Other identifiers 1

IdentifierTypeStateIssuer
01630237OtherILBCBS

Other names 1

  • Jackson Park Medical Associates Doing business as

National Provider Directory

National Provider Directory

Locations

7531 S Stony Island Ave
#176
Chicago, IL 60649
Phone (773) 947-7746

Practitioners & affiliated clinicians

Practitioners 2

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": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299801600000",
    "number": "1851504161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7531 SO STONY ISLAND",
            "address_2": "ST 176",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60649",
            "telephone_number": "773-947-7746",
            "fax_number": "773-947-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7531 SO STONY ISLAND",
            "address_2": "ST 176",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60649",
            "telephone_number": "773-947-7746",
            "fax_number": "773-947-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED MEDICAL CENTERS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2011-03-11",
        "status": "A",
        "authorized_official_last_name": "FOREMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-947-7746",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "042004703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01630237",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Park Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.