SUPREME MD INC.
Family Medicine

Address: 5737 N Talman Ave Apt 2, Chicago, IL 60659-5097

SUPREME MD INC. (NPI# 1366032724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366032724
Entity Type Organization
Organization Name SUPREME MD INC.
Practice Address 5737 N Talman Ave Apt 2
Chicago
IL 60659-5097
Practice Telephone 7733296545
Mailing Address 5737 N Talman Ave Apt 2
Chicago
IL 60659-5097
Mailing Telephone 7733296545
Certification Date 2021-01-20
Enumeration Date 2021-01-20
Last Update Date 2021-01-20
Authorized Official Telephone 7733296545
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Taxonomy Group
N 207Q00000X Family Medicine 193200000X MULTI-SPECIALTY GROUP Allopathic & Osteopathic Physicians
N 207R00000X Internal Medicine 193200000X MULTI-SPECIALTY GROUP Allopathic & Osteopathic Physicians
N 251F00000X Home Infusion Agencies
Y 207QG0300X Family Medicine
Specialization: Geriatric Medicine
193200000X MULTI-SPECIALTY GROUP Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Supreme MD Doing Business As Name

Office Location

Street Address 5737 N TALMAN AVE APT 2
City CHICAGO
State IL
Zip Code 60659-5097

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1043811425 Devon Homecare Physicians Inc. Family Medicine · Adult Medicine 2822 W. Granville Ave. Apt 1, Chicago, IL 60659 2020-11-03
1932724200 Tatyana Menaker Nurse Practitioner · Adult Health 2958 West Devon Ave, Chicago, IL 60659 2020-06-12
1508410069 Kara Lyn Anderson Counselor · Mental Health 2551 W. Peterson Ave, Chicago, IL 60659 2019-08-01
1568980019 Saba Suleman Counselor · Mental Health 5815 N Spaulding Ave Apt 3a, Chicago, IL 60659 2017-09-05
1639695257 Go Diagnostics Inc Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 5862 N Lincoln Ave, Suite 4, Chicago, IL 60659 2017-08-15
1972039568 Trilogy, Inc. Community/Behavioral Health 2551 W Peterson Ave, Chicago, IL 60659 2017-05-03
1689029050 Soulu · Madraigos Midwest Voluntary or Charitable 3557 W Peterson Ave #122, Chicago, IL 60659 2016-05-04
1730540550 Michael Wei-Tsi Chien Dentist 3425 W Peterson Ave Ste 107, Chicago, IL 60659 2016-03-08
1497129688 Acquaint Homecare LLC Home Health 3525 West Peterson Avenue, Unit 118, Chicago, IL 60659 2015-11-25
1083054621 Rebecca Schnell Speech-Language Pathologist 6124 N Saint Louis Ave, Chicago, IL 60659 2013-06-27
Find all providers in zip 60659

Taxonomy Information

Taxonomy Code 207QG0300X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Geriatric Medicine

Taxonomy Definition

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982225918 Welcome Health Management Group 2325 W Harrison St Apt 2, Chicago, IL 60612-3555 2020-04-30
1508419367 Well Kept Elder Enterprises, LLC · Well Kept Elder Enterprises, LLC 18 S Michigan Ave, Chicago, IL 60603-3200 2019-07-22
1548618549 Anna Breen Liggett 675 N Saint Clair St Ste 18-200, Chicago, IL 60611-5929 2016-05-31
1962878264 Integrative Healthcare Network 7531 S Stony Island Ave, Suite 164, Chicago, IL 60649-3954 2015-08-20
1114362456 Asap Wellness Center, Sc 730 S Dearborn St, Chicago, IL 60605-1838 2013-04-30
1255698809 Laura Amanda Perry 722 W Maxwell St Ste 235, Chicago, IL 60607 2012-04-20
1366708117 Ria Luz Parcellano 1715 E 95th St, Chicago, IL 60617-4708 2012-04-05
1316219546 Mark Grant 225 N Michigan Ave, Bcbsa, Chicago, IL 60601-7757 2012-02-03
1861703928 Magdalena Bednarczyk 1725 W Harrison St, Suite 955, Chicago, IL 60612-3841 2010-06-23
1255519310 Carol Krohm 2611 W Chicago Ave, Chicago, IL 60622 2008-01-31
Find all providers in CHICAGO

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City CHICAGO
Zip Code 60659

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Dataset Information

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.