Individual provider Active NPI

Charilaos Papafragkakis

  • Student in an Organized Health Care Education/Training Program
  • Chicago, IL
National Provider Identifier
1902070691
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
036118241 Issued in IL
Practice address
856 W Wellington Ave
Internal Medicine Department
Chicago, IL 60657
Phone
(773) 296-7635
NPI assigned
Apr 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 036118241 IL Primary

Addresses

Primary practice location

856 W Wellington Ave
Internal Medicine Department
Chicago, IL 60657

Mailing address

856 W Nelson St
Apt#1803
Chicago, IL 60657-5152
Phone (773) 329-7785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
036118241ILMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1902070691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 W NELSON ST",
            "address_2": "APT#1803",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575152",
            "telephone_number": "773-329-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 W WELLINGTON AVE",
            "address_2": "INTERNAL MEDICINE DEPARTMENT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-296-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPAFRAGKAKIS",
        "first_name": "CHARILAOS",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "036118241",
            "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 Apr 15, 2008; 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.