Active NPI
Sameer Bhalla
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1962066365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 1962066365
- Practice address
- 600 S Paulina St
Chicago, IL 60612-3806 - Phone
- (312) 942-7100
- NPI assigned
- May 1, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 1962066365 | IL | Primary |
Addresses
Primary practice location
600 S Paulina St
Chicago, IL 60612-3806
Mailing address
600 S Paulina St
Chicago, IL 60612-3806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1962066365 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624060800000",
"number": "1962066365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 S PAULINA ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 S PAULINA ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123806",
"telephone_number": "312-942-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BHALLA",
"first_name": "SAMEER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-01",
"last_updated": "2021-06-19",
"certification_date": "2021-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "1962066365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jun 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.