Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Chicago Community Medical Center

Organization Family Medicine Physician · NPI 1306851233

Chicago Community Medical Center provides Family Medicine Physician services in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006

Practice location Address checks out

2404 E 79th St
Chicago, IL 60649-5112
Phone: (773) 978-5900
Fax: (773) 978-7656
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (IL)

Record details

NPI number1306851233
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Prem Paul — Treasurer · (773) 978-5900
NPI enumeratedJuly 29, 2006
Last updated in NPPESAugust 22, 2020
Mailing address155 Harbor Point #5212, Chicago, IL 60601-7381

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