FAMILY CARE ASSOCIATES OF CHICAGO (NPI# 1023065976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023065976 |
| Entity Type | Organization |
| Organization Name | FAMILY CARE ASSOCIATES OF CHICAGO |
| Practice Address |
6187 S Archer Ave Suite 103 Chicago IL 60638-2605 |
| Practice Telephone | 7735811500 |
| Practice Fax Number | 7735812160 |
| Mailing Telephone | 7735811500 |
| Mailing Fax Number | 7735812160 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2016-07-21 |
| Authorized Official Name | DR. CHARLES SHAW (MEMBER) |
| Authorized Official Telephone | 7735811500 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RAILROAD GROUP # | CL4550 | 01 |
| IL | BLUE CROSS BLUE SHIELD # | 1618283 | 01 |
| Street Address |
6187 S ARCHER AVE SUITE 103 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60638-2605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720086960 | Charles T Shaw | Internal Medicine | 6187 S Archer Ave, Suite 103, Chicago, IL 60638-2605 | 2005-07-12 |
| 1750589875 | David Dionisio | Family Medicine | 6187 S Archer Ave, Suite 103, Chicago, IL 60638-2605 | 2007-07-10 |
| 1659492759 | Thomas R. Mizen, M.d. and Associates, LLC | Ophthalmology | 6187 S Archer Ave, Suite 101, Chicago, IL 60638-2605 | 2007-04-03 |
| 1639280530 | Thomas R Mizen | Ophthalmology | 6187 S Archer Ave, Suite 101, Chicago, IL 60638-2605 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931952 | Dawid Bula | Pharmacist | 7090 S Cicero Ave, Bedford Park, IL 60638 | 2020-10-30 |
| 1386278430 | Adara Simonelli | Physician Assistant | 6317 S Lorel Avenue, Chicago, IL 60638 | 2020-02-27 |
| 1891343711 | Marie Dipasquale | Technician | 5837 So. Natoma Ave, Chgo, IL 60638 | 2019-09-04 |
| 1316434400 | Ab Dental Professionals LLC | Dentist | 5672 South Archer Avenue, Chicago, IL 60638 | 2018-04-16 |
| 1427563204 | Bethany Elkington | Occupational Therapist | 5764 South Archer Ave, Chicago, IL 60638 | 2017-12-03 |
| 1952759854 | Ismael Gutierrez | Family Medicine | 6084 W Archer Ave, Chicago, IL 60638 | 2016-06-01 |
| 1336533314 | Claude Lucas King | Counselor | 6235 S Major Ave Apt 1, Chicago, IL 60638 | 2015-03-27 |
| 1538594395 | Mohammad Joudeh | Chiropractor | 4844 S Cicero Ave, Chicago, IL 60638 | 2013-09-11 |
| 1548602428 | Clearing Vision Professional Corporation | Optometrist | 5718 W. 63rd St., Chicago, IL 60638 | 2013-07-22 |
| 1184963134 | Raquel Ana Eguia | Physical Therapist | 5658 S. Parkside Ave, Chicago, IL 60638 | 2013-02-12 |
| Find all providers in zip 60638 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1124645700 | Timothy Alan Williams Jr. | Family Medicine | 1625 E 75th St Fl 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1194340026 | Kaysha Lynne Ribao | Family Medicine | 2116 S Springfield Ave, Chicago, IL 60623-2465 | 2020-06-16 |
| 1932724341 | Toni Kurian | Family Medicine | 1550 S Indiana Ave Apt 407, Chicago, IL 60605-4822 | 2020-06-11 |
| 1528689486 | Thurman J Robertson | Family Medicine | 1950 W. Polk Street, 7th Floor, Chicago, IL 60612-3714 | 2020-05-01 |
| 1629697297 | Lyndsey Danielle Johnson | Family Medicine | 2804 W Walton St, Chicago, IL 60622-4450 | 2020-04-13 |
| 1730708884 | Iruoma Genevieve Nwangwu | Family Medicine | 1950 W Polk Street, Chicago, IL 60612-3714 | 2020-04-09 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.