Individual provider Active NPI

George Sousanieh, MD

  • Nephrology Physician
  • Evergreen Park, IL
National Provider Identifier
1033514625
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036142389 Issued in IL
Practice address
9125 S Pulaski Rd
Evergreen Park, IL 60805-1441
Phone
(708) 422-7715
NPI assigned
Oct 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125065808 IL
Nephrology Physician 207RN0300X 036142389 IL Primary

Addresses

Primary practice location

9125 S Pulaski Rd
Evergreen Park, IL 60805-1441

Mailing address

120 W 22ND St Ste 200
Oak Brook, IL 60523-1563
Phone (630) 573-5000

Other practice location 1

16605 107th St
Orland Park, IL 60467-9016
Phone (708) 226-9860

Electronic endpoints 5

TypeEndpointUseAffiliation
Direct Messaging Address swnamd@directaddress.net Direct
Direct Messaging Address swnamd@directaddress.net Direct
Direct Messaging Address gsousanieh276396@direct.myadvocateaurora.org Direct
Direct Messaging Address credentialing@nephdocs.com Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20171223000000 IL Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Hospitalist 9032477906 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Hospitalist, Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Nephrology Associates, S.C.Group PAC ID 1557335460, 13 clinicians

Practice addresses (Care Compare)

12250 S Cicero Ave
Suite 112
Alsip, IL 60803-2946
Phone (708) 371-5308

16605 S 107TH CT
Orland Park, IL 60467-9016
Phone (708) 422-7715

800 Biesterfield Rd
Elk Grove Village, IL 60007-3372
Phone (847) 981-3680

9125 S Pulaski Rd
Evergreen Park, IL 60805-1441
Phone (708) 422-7715

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125065808ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Northern Illinois, LTD. Nephrology CurrentSince Dec 1, 2021 Accepting new patients
Nephrology Associates of Northern Illinois, LTD. Nephrology CurrentSince Dec 1, 2021 Accepting new patients
Southwest Nephrology Associates, S.C. Nephrology CurrentSince Jul 13, 2020 Accepting new patients
Endeavor Health Medical Group Internal Medicine Past Accepting new patients

Locations

2055 W Army Trail Rd
Ste 110N
Addison, IL 60101
Phone (773) 284-9247

12250 S Cicero Ave
Ste 112
Alsip, IL 60803
Phone (708) 371-5308

3223 W 63rd St
Chicago, IL 60629
Phone (773) 735-4884

800 Biesterfield Rd
Ste 104
Elk Grove Village, IL 60007
Phone (847) 593-9182

9125 S Pulaski Rd
Evergreen Pk, IL 60805
Phone (708) 422-7715

120 W 22nd St
Oak Brook, IL 60523

120 W 22nd St
Ste 200
Oak Brook, IL 60523
Phone (630) 575-5000

16605 107th St
Orland Park, IL 60467
Phone (708) 226-9860

Interoperability endpoints

  • Direct secure messaging: akash.ahuja.p21@direct.nani.nextgenshare.com
  • Direct secure messaging: gsousanieh276396@direct.myadvocateaurora.org
  • Direct secure messaging: gsousanieh24807@direct.acumenmd.com
  • Direct secure messaging: george.sousanieh.p21@direct.nani.nextgenshare.com

Organizations & group practices 4

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

Hospital & facility affiliations 10

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": "1414281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1033514625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-573-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9125 S PULASKI RD",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051441",
            "telephone_number": "708-422-7715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16605 107th St",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604679016",
            "country_code": "US",
            "telephone_number": "708-226-9860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUSANIEH",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-26",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125065808",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036142389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swnamd@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "16605 107th St",
            "city": "Orland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604679016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swnamd@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9125 S Pulaski Rd",
            "city": "Evergreen Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608051441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gsousanieh276396@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9125 S Pulaski Rd",
            "city": "Evergreen Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608051441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 W 22nd St",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "9125 S Pulaski Rd",
            "city": "Evergreen Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608051441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.