Chicago Weight Loss Clinic, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036044803 Issued in IL

Legal business name

CHICAGO WEIGHT LOSS CLINIC, LLC

Practice address

1 E Superior St
# 306
Chicago, IL 60611-2507

Phone

(312) 565-1010

Fax

(312) 565-1212

NPI assigned

Jun 3, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Dharam Paul

Title

Managing Member

Phone

(312) 565-1010

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275609600000",
    "number": "1932429784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N HARBOR DR",
            "address_2": "# 5212",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017364",
            "telephone_number": "312-565-1010",
            "fax_number": "312-565-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E SUPERIOR ST",
            "address_2": "# 306",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112507",
            "telephone_number": "312-565-1010",
            "fax_number": "312-565-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO WEIGHT LOSS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-06-04",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "DHARAM",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "312-565-1010",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036044803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; 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.