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SOUTHSIDE FAMILY MEDICINE PC
NPI 1922361450
Family Medicine in Chicago, IL

Active since June 19, 2012
1525 E 55TH ST, SUITE 307, CHICAGO, IL 60615(773) 667-5577(773) 667-9977 Get Directions Write a Review

NPPES record last updated: June 19, 2012. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Southside Family Medicine Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHSIDE FAMILY MEDICINE PC (NPI 1922361450) is a healthcare organization registered as a family medicine in Chicago, Illinois and active in the NPI registry since June 2012. The organization lists Carlos J. Crudup, President, as its authorized official.

NPPES Registry Identity

NPI1922361450
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTHSIDE FAMILY MEDICINE PC
Location Address1525 E 55TH ST, SUITE 307Chicago, IL 60615-5512
Mailing Address1446 E 63rd StChicago, IL 60637-2948 · (773) 230-2741
Phone(773) 667-5577
Fax(773) 667-9977
Organization SubpartNo
Authorized OfficialCarlos J. CrudupPresident · (773) 667-5577
Enumeration DateJune 19, 2012
✔ NPI 1922361450 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 336.073573
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1525 E 55TH ST, Chicago, IL 60615
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. LAUREN REBECCA KOBY PSYD
Psychologist (Clinical)
1525 E 55TH ST
CHICAGO, IL 60615
Cook County (773) 388-1600
AISHA MUKES COSMETOLGY
Prosthetic/Orthotic Supplier
1525 E 55TH ST
CHICAGO, IL 60615
Cook County (773) 301-2833
CRYSTAL SWENSON LPC
Counselor (Professional)
1525 E 55TH ST
CHICAGO, IL 60615
Cook County (773) 388-1600
DR. ROMINA KEE M.D.
Obstetrics & Gynecology
1525 E 55TH ST
CHICAGO, IL 60615
Cook County (773) 388-1600
JULIA SOMERVILLE LCSW
Social Worker (Clinical)
1525 E 55TH ST, SUITE 301B
CHICAGO, IL 60615
Cook County (312) 475-0212
INDIA R WILLIS APN
Nurse Practitioner (Family)
1525 E 55TH ST
CHICAGO, IL 60615
Cook County (773) 388-1600
SAMANTHA DEVENEY LIN FNP-BC, MS, MPH
Nurse Practitioner (Family)
1525 E 55TH ST
CHICAGO, IL 60615
Cook County (212) 305-5756
ATTUNE INC
Clinic/Center (Occupational Medicine)
1525 E 55TH ST, SUITE 304
CHICAGO, IL 60615
Cook County (773) 363-5450

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southside Family Medicine PC's NPI number?

The NPI number for Southside Family Medicine PC is 1922361450. It was assigned to this organization in the NPPES registry on June 19, 2012.

Where is Southside Family Medicine PC located?

Southside Family Medicine PC is located at 1525 E 55th St Suite 307, Chicago, IL 60615. The listed phone number is (773) 667-5577.

What is Southside Family Medicine PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Southside Family Medicine PC was last updated on June 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.