Individual provider Active NPI

Tony S. Fu, M.D.

  • Dermatology Physician
  • Evanston, IL
National Provider Identifier
1043383524
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
3648697 Issued in IL
Practice address
636 Church St Ste 222
Evanston, IL 60201-4578
Phone
(847) 328-3913
Fax
(847) 328-3952
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 3648697 IL Primary
Dermatopathology Physician 207ND0900X 3648697 IL
Procedural Dermatology Physician 207NS0135X 3648697 IL

Addresses

Primary practice location

636 Church St Ste 222
Evanston, IL 60201-4578

Mailing address

636 Church St Ste 222
Evanston, IL 60201-4578
Phone (847) 328-3913

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
I20060303000023 IL Practitioner - DermatologyPractitioner - Pathology 6002822822 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pathology
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renuka H Bhatt MDSCGroup PAC ID 1557378478, 7 clinicians

Practice addresses (Care Compare)

120 Batson CT
Suite 201
New Lenox, IL 60451-1579
Phone (815) 717-8606

636 Church St
Suite 308
Evanston, IL 60201-6030
Phone (847) 328-3913

Merit-based Incentive Payment System (MIPS)

Final score
96.77 of 100Reported as group
Quality
93.53
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision181
Removal of skin lesions1-10
Skin biopsy14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3648697ILMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tony Fu MD SC Dermatology CurrentSince Jan 1, 2004 Accepting new patients
Renuka H Bhatt MDSC Dermatology CurrentSince Jun 1, 2016 Accepting new patients
Brian M Wu MD SC Past Accepting new patients

Locations

6315 Northwest Hwy
Ste B
Crystal Lake, IL 60014
Phone (815) 459-4333

6317 N West Hwy
Crystal Lake, IL 60014
Phone (815) 459-4333

636 Church St
Ste 308
Evanston, IL 60201
Phone (847) 328-3913

636 Church St
Ste 222
Evanston, IL 60201
Phone (847) 328-3913

636 Church St
Ste 508
Evanston, IL 60201
Phone (773) 669-8616

2202 Essington Rd
Ste 101
Joliet, IL 60435
Phone (815) 676-5310

120 Batson Ct
New Lenox, IL 60451
Phone (815) 717-8515

120 Batson Ct
Ste 201
New Lenox, IL 60451
Phone (630) 640-6090

10811 W 143rd St
Orland Park, IL 60467
Phone (708) 226-0044

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1043383524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST STE 222",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014578",
            "telephone_number": "847-328-3913",
            "fax_number": "847-328-3952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST STE 222",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014578",
            "telephone_number": "847-328-3913",
            "fax_number": "847-328-3952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FU",
        "first_name": "TONY",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "3648697",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "IL",
            "license": "3648697",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "IL",
            "license": "3648697",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.