Organization Active NPI

Leticia F Claridad MD PC

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1912164351
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036077152 Issued in IL
Legal business name
LETICIA F CLARIDAD MD PC
Practice address
3042 W Fullerton
Chicago, IL 60647-2808
Phone
(773) 252-9400
Fax
(773) 252-9540
NPI assigned
May 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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

Authorized official

Name
Leticia Flores Claridad, M.D.
Title
Physician
Phone
(773) 252-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 036077152 IL Primary

Addresses

Primary practice location

3042 W Fullerton
Chicago, IL 60647-2808

Mailing address

3042 W Fullerton
Chicago, IL 60647-2808
Phone (773) 252-9400

Other names 1

  • Fullerton Albany Womens Clinic Other name

National Provider Directory

National Provider Directory

Locations

3042 W Fullerton Ave
Chicago, IL 60647
Phone (773) 252-9400

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223942400000",
    "number": "1912164351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3042 W FULLERTON",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472808",
            "telephone_number": "773-252-9400",
            "fax_number": "773-252-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3042 W FULLERTON",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472808",
            "telephone_number": "773-252-9400",
            "fax_number": "773-252-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LETICIA F CLARIDAD MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-10-14",
        "status": "A",
        "authorized_official_last_name": "CLARIDAD",
        "authorized_official_first_name": "LETICIA",
        "authorized_official_middle_name": "FLORES",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "773-252-9400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036077152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fullerton Albany Womens Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 14, 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.