Individual provider Active NPI

Ariel Chavez, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1902978257
Registry record updated Apr 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036054596 Issued in IL
Practice address
4608 S Ashland Ave
Chicago, IL 60609
Phone
(773) 927-7573
Fax
(773) 927-7382
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2010

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 036054596 IL Primary

Addresses

Primary practice location

4608 S Ashland Ave
Chicago, IL 60609

Mailing address

PO Box 597202
Chicago, IL 60659
Phone (773) 927-7573

Other identifiers 3

IdentifierTypeStateIssuer
363306485OtherTAX ID
036054596MedicaidIL
21606887OtherILBCBS

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100329000200 IL Practitioner - Internal Medicine 8527194620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4614 S Ashland Ave
Chicago, IL 60609-3251
Phone (773) 927-7573

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036054596ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ariel Chavez MD SC Internal Medicine CurrentSince Dec 10, 2009 Accepting new patients

Locations

4614 S Ashland Ave
Fl First
Chicago, IL 60609

4608 S Ashland Ave
Chicago, IL 60609
Phone (773) 927-7573

4614 S Ashland Ave
Chicago, IL 60609
Phone (773) 888-2560

Organizations & group practices 1

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

Hospital & facility affiliations 8

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272585600000",
    "number": "1902978257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 597202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-927-7573",
            "fax_number": "773-927-7382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4608 S ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60609",
            "telephone_number": "773-927-7573",
            "fax_number": "773-927-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "ARIEL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2010-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036054596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "363306485",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036054596",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "21606887",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.