Individual provider Active NPI

Nicholas Marcel De la Rua, MD

  • Pulmonary Disease Physician
  • Chicago, IL
National Provider Identifier
1063074094
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036.159353 Issued in IL
Practice address
7447 W Talcott Ave Ste 542
Chicago, IL 60631-3716
Phone
(773) 631-2180
Fax
(773) 631-5947
NPI assigned
Jun 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 036.159353 IL Primary
Internal Medicine Physician 207R00000X 125.075168 IL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036.159353 IL
Pulmonary Disease Physician 207RP1001X 036159353 IL

Addresses

Primary practice location

7447 W Talcott Ave Ste 542
Chicago, IL 60631-3716

Mailing address

7447 W Talcott Ave Ste 542
Chicago, IL 60631-3716
Phone (773) 631-2180

Other practice location 1

5841 S Maryland Ave Ste Mc6076
Chicago, IL 60637-1626
Phone (773) 702-9660

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
I20250421001505 IL Practitioner - Pulmonary Disease 6800123597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Louisiana State University School of Medicine in New Orleans, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Pulmonary Associates, S.C.Group PAC ID 2466494075, 9 clinicians

Practice addresses (Care Compare)

7447 W Talcott Ave
Suite 542
Chicago, IL 60631-3716
Phone (773) 631-2180

Hospital & facility affiliations

  • Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117
  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
  • Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080
  • Holy Family Medical Center Long-term care hospital, Des Plaines, IL, CCN 142011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.075168ILMDInternal Medicine Physician
036.159353ILMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Pulmonary Associates, S.C. Pulmonary Disease CurrentSince Jun 16, 2025 Accepting new patients
Cardiothoracic & Vascular Surgical Associates S C PastSince Apr 20, 2025 Accepting new patients

Locations

7447 W Talcott Ave
Chicago, IL 60631
Phone (773) 631-6082

7447 W Talcott Ave
Ste 542
Chicago, IL 60631
Phone (773) 631-2180

Organizations & group practices 2

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 4

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": "1561766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1063074094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE STE 542",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313716",
            "telephone_number": "773-631-2180",
            "fax_number": "773-631-5947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE STE 542",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313716",
            "telephone_number": "773-631-2180",
            "fax_number": "773-631-5947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave Ste Mc6076",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371626",
            "country_code": "US",
            "telephone_number": "773-702-9660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA RUA",
        "first_name": "NICHOLAS",
        "middle_name": "MARCEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-29",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036.159353",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.075168",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036.159353",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036159353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.