Individual provider Active NPI

Carl K Atallah, DO

  • Gastroenterology Physician
  • Chicago, IL
National Provider Identifier
1922269190
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036127620 Issued in IL
Practice address
3000 N Halsted St Ste 623
Chicago, IL 60657-5196
Phone
(773) 281-5818
Fax
(773) 281-6859
NPI assigned
Jun 20, 2008
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036127620 IL Primary

Addresses

Primary practice location

3000 N Halsted St Ste 623
Chicago, IL 60657-5196

Mailing address

3000 N Halsted St Ste 623
Chicago, IL 60657-5196
Phone (773) 281-5818

Other identifiers 1

IdentifierTypeStateIssuer
F400145031OtherILPTAN

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
I20120327000935 IL Practitioner - Internal MedicinePractitioner - Gastroenterology 7315107414 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Gi LLCGroup PAC ID 7416205414, 5 clinicians

Practice addresses (Care Compare)

3000 N Halsted St
Chicago, IL 60657-5196
Phone (773) 281-5818

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy120
Upper gastrointestinal (GI) endoscopy for acid reflux100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thorek Memorial Hospital CurrentSince Nov 26, 2024 Accepting new patients
Advanced Gi, LLC Gastroenterology CurrentSince Jun 20, 2018 Accepting new patients
Thorek Memorial Hospital CurrentSince Nov 26, 2024 Accepting new patients

Locations

3000 N Halsted St
Ste 623
Chicago, IL 60657
Phone (773) 281-5818

3000 N Halsted St
Ste 625
Chicago, IL 60657
Phone (773) 296-3450

840 W Irving Park Rd
#301
Chicago, IL 60613
Phone (240) 245-0890

Interoperability endpoints

  • Direct secure messaging: catallah@gis.gwaydirect.com

Organizations & group practices 3

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

Hospital & facility affiliations 4

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": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1922269190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST STE 623",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575196",
            "telephone_number": "773-281-5818",
            "fax_number": "773-281-6859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST STE 623",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575196",
            "telephone_number": "773-281-5818",
            "fax_number": "773-281-6859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATALLAH",
        "first_name": "CARL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036127620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "F400145031",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.