OrganizationActive
Chicago Community Medical Center
NPI 1306851233 · Family Medicine Physician · Chicago, IL
Provider details
- NPI number
- 1306851233
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Prem Paul, Treasurer(773) 978-5900
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2404 East 79th St
Chicago, IL 60649-5112
Phone: (773) 978-5900
Fax: (773) 978-7656
Street-level locationGet directions
Mailing address
155 Harbor Point #5212
Chicago, IL 60601-7381
Registry dates
- Enumerated
- 2006-07-29
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.