OrganizationActive
The Black House Group LLC
NPI 1457011306 · Internal Medicine Physician · Chicago, IL
Provider details
- NPI number
- 1457011306
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tequilla Stanciel, Founder & Chief Medical Provider(312) 860-4814
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
611 S Wells St Apt 803
Chicago, IL 60607-4783
Phone: (312) 860-4814
Street-level locationGet directions
Mailing address
611 S Wells St Apt 803
Chicago, IL 60607-4783
Other names (DBA / former)
- Doing business as
- Healthsquad
Registry dates
- Enumerated
- 2021-12-20
- Last updated
- 2021-12-20
- Certified
- 2021-12-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.