NPIMap

Organization Active NPI

Dr.Charles Clifford Alston SC

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1982878856
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
DR.CHARLES CLIFFORD ALSTON SC
Practice address
2017 W 95TH St
Chicago, IL 60643-1115
Phone
(773) 779-2280
NPI assigned
Apr 22, 2008
Last updated
Mar 31, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Authorized official

Name
Dr. Charles AlstonNPI 1922070382
Title
Doctor
Phone
(773) 779-2801

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

2017 W 95TH St
Chicago, IL 60643-1115

Mailing address

2017 W 95TH St
Chicago, IL 60643-1115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040922001174 IL Part B Supplier - Clinic/Group Practice 2466420815 Receives reassigned benefits from 3 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

2017 W 95th St
Chicago, IL 60643
Phone (773) 779-2280

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1982878856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 W 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 W 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431115",
            "telephone_number": "773-779-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR.CHARLES CLIFFORD ALSTON SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "ALSTON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "773-779-2801",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "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 Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.