Organization Active NPI

Striedinger Medical Group SC

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1023197332
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036090741 Issued in IL
Legal business name
STRIEDINGER MEDICAL GROUP SC
Practice address
4733 N Damen Ave
Chicago, IL 60625-1442
Phone
(773) 878-4700
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Authorized official

Name
Dr. Fernando M Striedinger, MDNPI 1851483119
Title
Internal Medicine
Phone
(773) 878-4700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 036090741 IL Primary

Addresses

Primary practice location

4733 N Damen Ave
Chicago, IL 60625-1442

Mailing address

4733 N Damen
Chicago, IL 60625-1334
Phone (773) 878-4700

Other identifiers 2

IdentifierTypeStateIssuer
036090741MedicaidIL
4932289OtherILBCBS PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040528000982 IL Part B Supplier - Clinic/Group Practice 2567443096 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2085061Striedinger Medical Group SC4733 N Damen Ave, Chicago, IL 60625Certificate of waiverOct 6, 2026

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8541/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428537600000",
    "number": "1023197332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4733 N DAMEN",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251334",
            "telephone_number": "773-878-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4733 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251442",
            "telephone_number": "773-878-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRIEDINGER MEDICAL GROUP SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2015-04-09",
        "status": "A",
        "authorized_official_last_name": "STRIEDINGER",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "INTERNAL MEDICINE",
        "authorized_official_telephone_number": "773-878-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036090741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090741",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER",
            "identifier": "4932289",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.