NPIMap

Individual provider Active NPI

Irene Blanco, MD

  • Rheumatology Physician
  • Chicago, IL
National Provider Identifier
1104074244
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036161539 Issued in IL
Practice address
675 N Saint Clair St Ste 14-100
Chicago, IL 60611-5966
Phone
(312) 695-8628
Fax
(312) 695-0114
NPI assigned
Sep 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 240409 NY
Rheumatology Physician 207RR0500X 036161539 IL Primary

Addresses

Primary practice location

675 N Saint Clair St Ste 14-100
Chicago, IL 60611-5966

Mailing address

675 N Saint Clair St Ste 14-100
Chicago, IL 60611-5966
Phone (312) 695-8628

Other practice location 1

1300 Morris Park Ave
Department of Rheumatology Forchheimer 701
Bronx, NY 10461-1900
Phone (718) 430-2078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090727000361 NY Practitioner - RheumatologyPractitioner - Internal Medicine 1658424445 Reassigns benefits to 1 organization
I20220829001730 IL Practitioner - RheumatologyPractitioner - Internal Medicine 1658424445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

675 N St Clair
250 Dept of Rheumatology
Chicago, IL 60611-5975
Phone (312) 695-8628

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Shirley Ryan Abilitylab Inpatient rehabilitation facility, Chicago, IL, CCN 143026

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

Practice roles (5 of 9)

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 26, 2009 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2022 Accepting new patients
Montefiore Medical Center Rheumatology CurrentSince Jun 26, 2009 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2022 Accepting new patients
Central Dupage Physician Group Rheumatology Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

675 N Saint Clair St
Ste 14-100
Chicago, IL 60611
Phone (312) 695-8628

675 N Saint Clair St
Ste 14100
Chicago, IL 60611
Phone (312) 695-7970

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

111 E 210th St
Bronx, NY 10467

3411 Wayne Ave
Fl 2
Bronx, NY 10467

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 6

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1104074244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 14-100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115966",
            "telephone_number": "312-695-8628",
            "fax_number": "312-695-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 14-100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115966",
            "telephone_number": "312-695-8628",
            "fax_number": "312-695-0114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Morris Park Ave",
            "address_2": "Department of Rheumatology Forchheimer 701",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104611900",
            "country_code": "US",
            "telephone_number": "718-430-2078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "IRENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "240409",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036161539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.