NPIMap

Individual provider Active NPI

Charlemagne G Guerrero, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1871715540
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036124775 Issued in IL
Practice address
5641 W Irving Park Rd
Chicago, IL 60634-2742
Phone
(773) 635-5700
Fax
(773) 635-5050
NPI assigned
May 3, 2007
Last updated
Sep 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036124775 IL Primary

Addresses

Primary practice location

5641 W Irving Park Rd
Chicago, IL 60634-2742

Mailing address

2900 N 76TH CT
Elmwood Park, IL 60707-1101
Phone (773) 635-5700

Other identifiers 2

IdentifierTypeStateIssuer
P01157998OtherILRAILROAD MEDICARE PTAN
036124775MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101113000218 IL Practitioner - Internal Medicine 5294920401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5600 W Addison St
Suite 406
Chicago, IL 60634-4485
Phone (773) 635-5700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Northwest Chicago Primary Care SC Internal Medicine CurrentSince May 1, 2012 Accepting new patients
Birinder S Marwah MD LTD Internal Medicine Past Accepting new patients
Suburban Home Physicians,LLC Internal Medicine Past Accepting new patients

Locations

3919 W Foster Ave
Chicago, IL 60625
Phone (773) 588-9500

5600 W Addison St
Ste 406
Chicago, IL 60634
Phone (773) 205-9800

5600 W Addison St
Ste 505
Chicago, IL 60634
Phone (773) 282-3311

5641 W Irving Park Rd
Chicago, IL 60634
Phone (773) 282-2520

Interoperability endpoints

  • Direct secure messaging: cguerrero78766@direct.luhs.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/DFFBCA
  • FHIR API: https://fhir4.healow.com/fhir/r4/DFFBCA/Endpoint/DFFBCA

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1871715540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N 76TH CT",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607071101",
            "telephone_number": "773-635-5700",
            "fax_number": "773-635-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5641 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342742",
            "telephone_number": "773-635-5700",
            "fax_number": "773-635-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "CHARLEMAGNE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036124775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P01157998",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036124775",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.