| Chicago Medical Group, Inc. | |
|
159 N Sangamon St Ste 200 Chicago IL 60607-2201 | |
| (833) 387-7440 | |
| Not Available |
| Full Name | Chicago Medical Group, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 159 N Sangamon St Ste 200, Chicago, Illinois |
| Authorized Official Name and Position | James V Villar (MANAGING DIRECTOR) |
| Authorized Official Contact | 8473249728 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Medical Group, Inc. 159 N Sangamon St Ste 200 Chicago IL 60607-2201 Ph: (833) 387-7440 | Chicago Medical Group, Inc. 159 N Sangamon St Ste 200 Chicago IL 60607-2201 Ph: (833) 387-7440 |
| NPI Number | 1285972505 |
|---|---|
| Provider Enumeration Date | 01/21/2013 |
| Last Update Date | 06/22/2021 |
| Medicare PECOS PAC ID | 2961640222 |
|---|---|
| Medicare Enrollment ID | O20130528000058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285972505 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (Illinois) | Primary |
| Provider Name | Wilber P Yep |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124194659 PECOS PAC ID: 3274512777 Enrollment ID: I20040719000168 |
| Provider Name | Jordan D Grumet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093887705 PECOS PAC ID: 0749211746 Enrollment ID: I20050830000412 |
| Provider Name | Therese Hanigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942228978 PECOS PAC ID: 6800820606 Enrollment ID: I20050921000634 |
| Provider Name | William Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336555150 PECOS PAC ID: 7214152909 Enrollment ID: I20140714002125 |
| Provider Name | Lenita Hinkle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477948636 PECOS PAC ID: 0648599647 Enrollment ID: I20150619001248 |
| Provider Name | Maricela Garcia |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1184955866 PECOS PAC ID: 4284944844 Enrollment ID: I20151110003019 |
| Provider Name | Rachel Olugbenga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457869992 PECOS PAC ID: 1850653544 Enrollment ID: I20180316000441 |
| Provider Name | Edith A Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982142527 PECOS PAC ID: 2365702784 Enrollment ID: I20180405001841 |
| Provider Name | Karen Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376034991 PECOS PAC ID: 3870849268 Enrollment ID: I20180627000363 |
| Provider Name | Aree Lashawn Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558858910 PECOS PAC ID: 9133476443 Enrollment ID: I20180718001106 |
| Provider Name | Kelli Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508348590 PECOS PAC ID: 4082966395 Enrollment ID: I20181016000968 |
| Provider Name | Glory Obianuju Ikerodah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932675006 PECOS PAC ID: 8224382346 Enrollment ID: I20181108000904 |
| Provider Name | Guysela Youbi Nguemegni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790344018 PECOS PAC ID: 0042549818 Enrollment ID: I20190904003195 |
| Provider Name | Judith Mongoum Pene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134767759 PECOS PAC ID: 0547695736 Enrollment ID: I20200116000626 |
| Provider Name | Deanna S Bassette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578163515 PECOS PAC ID: 0345650826 Enrollment ID: I20201112001334 |
| Provider Name | Ashley Lucknise Descorbeth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770199051 PECOS PAC ID: 2860803434 Enrollment ID: I20201203000523 |
| Provider Name | Adepeju Ojomalade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710597281 PECOS PAC ID: 4385056845 Enrollment ID: I20201208000638 |
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