NPIMap

Organization Active NPI

Resilience Healthcare - Lakefront Medical Associates, LLC

  • Hematology & Oncology Physician
  • River Forest, IL
National Provider Identifier
1912470295
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
RESILIENCE HEALTHCARE - LAKEFRONT MEDICAL ASSOCIATES, LLC
Practice address
7420 Central Ave
River Forest, IL 60305-1800
Phone
(708) 763-2700
NPI assigned
Jan 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Authorized official

Name
Manoj Prasad
Title
Ceo
Phone
(708) 763-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

7420 Central Ave
River Forest, IL 60305-1800

Mailing address

4646 N Marine Dr
Chicago, IL 60640-5759

Other names 2

  • Chicago Health Medical Group Doing business as
  • CHMG - River Forest Cancer Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Chicago Health Medical Group14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1912470295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7420 CENTRAL AVE",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051800",
            "telephone_number": "708-763-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENCE HEALTHCARE - LAKEFRONT MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "PRASAD",
        "authorized_official_first_name": "MANOJ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-763-6700"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chicago Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chicago Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHMG - River Forest Cancer Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in River Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.