Individual provider Active NPI

Heather Cushing, MD

  • Obstetrics & Gynecology Physician
  • Glen Ellyn, IL
National Provider Identifier
1023093572
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036092063 Issued in IL
Practice address
800 Roosevelt Rd Ste 114
Glen Ellyn, IL 60137-5839
Phone
(630) 474-2626
Fax
(630) 474-2629
NPI assigned
Dec 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036092063 IL Primary

Addresses

Primary practice location

800 Roosevelt Rd Ste 114
Glen Ellyn, IL 60137-5839

Mailing address

800 Roosevelt Rd Ste 114
Glen Ellyn, IL 60137-5839
Phone (630) 474-2626

Other identifiers 1

IdentifierTypeStateIssuer
L007237OtherILCHAMPUS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050222000096 IL Practitioner - Obstetrics/Gynecology 5193778918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loyola University of Chicago, Stritch School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

800 Roosevelt Rd
Suite 114
Glen Ellyn, IL 60137-5839
Phone (630) 474-2626

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036092063ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SMC Medical Professionals LTD CurrentSince Jan 1, 2022 Accepting new patients

Locations

800 Roosevelt Rd
Ste 114
Glen Ellyn, IL 60137
Phone (630) 474-2626

800 Roosevelt Rd
Ste B114
Glen Ellyn, IL 60137
Phone (630) 474-2626

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1023093572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROOSEVELT RD STE 114",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375839",
            "telephone_number": "630-474-2626",
            "fax_number": "630-474-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROOSEVELT RD STE 114",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375839",
            "telephone_number": "630-474-2626",
            "fax_number": "630-474-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSHING",
        "first_name": "HEATHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036092063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "L007237",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

Verify at the official NPI Registry.