Individual provider Active NPI

Emily S Jungheim, MD

  • Reproductive Endocrinology Physician
  • Chicago, IL
National Provider Identifier
1073530572
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
2005006932 Issued in MO
Practice address
259 E Erie St Ste 2400
Chicago, IL 60611-3907
Phone
(312) 695-7269
NPI assigned
Jul 17, 2006
Last updated
Jan 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 2005006932 MO Primary

Addresses

Primary practice location

259 E Erie St Ste 2400
Chicago, IL 60611-3907

Mailing address

259 E Erie St Ste 2400
Chicago, IL 60611-3907
Phone (312) 695-7269

Other identifiers 2

IdentifierTypeStateIssuer
209406602MedicaidMO
ENROLLEDMedicaidIL

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
I20181102001329 IL Practitioner - Obstetrics/Gynecology 2860436151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loyola University of Chicago, Stritch School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2005006932MOMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2020 Accepting new patients
Central Dupage Physician Group Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

259 E Erie St
Ste 2400
Chicago, IL 60611
Phone (312) 694-9676

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1073530572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113907",
            "telephone_number": "312-695-7269",
            "fax_number": "312-695-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113907",
            "telephone_number": "312-695-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNGHEIM",
        "first_name": "EMILY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "MO",
            "license": "2005006932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209406602",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.