Individual provider Active NPI

Alexandra Seybold

  • Hospitalist Physician
  • Chicago, IL
National Provider Identifier
1083242184
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036.166715 Issued in IL
Practice address
1717 W Congress Pkwy
Chicago, IL 60612-3809
Phone
(312) 942-4200
NPI assigned
Apr 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.166715 IL
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 036.166715 IL Primary

Addresses

Primary practice location

1717 W Congress Pkwy
Chicago, IL 60612-3809

Mailing address

1717 W Congress Pkwy
Chicago, IL 60612-3809
Phone (312) 942-4200

Other practice location 1

8701 W Watertown Plank Rd
Milwaukee, WI 53226-3548
Phone (414) 955-4575

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231023001879 IL Practitioner - Hospitalist 9436574456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Midwestern University, Chicago College of Osteopathic Med, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1620 W Harrison St
Chicago, IL 60612-3801
Phone (312) 942-3034

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.166715ILMDHospitalist Physician
8618WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center CurrentSince Sep 11, 2023 Accepting new patients
Rush University Medical Group Internal Medicine CurrentSince Sep 11, 2023 Accepting new patients
Larabida Childrens Hospital PastSince Sep 10, 2023 Accepting new patients

Locations

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1620 W Harrison St
Chicago, IL 60612
Phone (312) 942-4200

75 Remittance Dr
Dept 1611
Chicago, IL 60675

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.

Hospital & facility affiliations 2

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1083242184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123809",
            "telephone_number": "312-942-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123809",
            "telephone_number": "312-942-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8701 W Watertown Plank Rd",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263548",
            "country_code": "US",
            "telephone_number": "414-955-4575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEYBOLD",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.166715",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036.166715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.