Michael William Earley, M. D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036067635 Issued in IL

Practice address

3623 W Chicago Ave
Chicago, IL 60651-3934

Phone

(773) 722-6171

Fax

(773) 722-7913

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1922107952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3623 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606513934",
            "telephone_number": "773-722-6171",
            "fax_number": "773-722-7913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3623 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606513934",
            "telephone_number": "773-722-6171",
            "fax_number": "773-722-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLEY",
        "first_name": "MICHAEL",
        "middle_name": "WILLIAM",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036067635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036067635",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maggie Earanky, LCSW
• Michael Earing
• Ava Joyce Earl
• Krystal Earle
• Megan M Earley, LCSW
• Ellawease Earls
• Early Dynamics
• Early Expressions Speech Therapy LLC
• Early Intervention Specialists
• Amy Early, OTR/L, OTD

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.