Active NPI
Derek Zhang
- Pediatrics Physician
- Chicago, IL
National Provider Identifier
1871358754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 125.084572
- Practice address
- Rush Adult and Pediatric Primary Care
1645 W Jackson Blvd Suite 215
Chicago, IL 60612-3276 - Phone
- (312) 942-8028
- NPI assigned
- Feb 19, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 125.084572 | IL | Primary |
Addresses
Primary practice location
Rush Adult and Pediatric Primary Care
1645 W Jackson Blvd Suite 215
Chicago, IL 60612-3276
Mailing address
Rush Adult and Pediatric Primary Care
1645 W Jackson Blvd Suite 215
Chicago, IL 60612-3276
Phone (312) 942-8028
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240814002606 | IL | Order and Referring Only - Internal Medicine | 2062950686 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.084572 | IL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725840000000",
"number": "1871358754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RUSH ADULT AND PEDIATRIC PRIMARY CARE",
"address_2": "1645 W JACKSON BLVD SUITE 215",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123276",
"telephone_number": "312-942-8028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RUSH ADULT AND PEDIATRIC PRIMARY CARE",
"address_2": "1645 W JACKSON BLVD SUITE 215",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123276",
"telephone_number": "312-942-8028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZHANG",
"first_name": "DEREK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-02-19",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "125.084572",
"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 Sep 9, 2024; 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.