Active NPI
Alisa McQueen
- Pediatrics Physician
- Chicago, IL
National Provider Identifier
1104865039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036121770
- Practice address
- 5841 S Maryland Ave
Chicago, IL 60637-1443 - Phone
- (888) 824-0200
- NPI assigned
- Jun 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | 036-121770 | IL | |
| Pediatrics Physician | 208000000X | 036121770 | IL | Primary |
Addresses
Primary practice location
5841 S Maryland Ave
Chicago, IL 60637-1443
Mailing address
150 Harvester Dr
Suite 300
Burr Ridge, IL 60527-5919
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | amcqueenmd22413@uchospital.direct-ci.com | University of Chicago Physicians Group |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-121770 | IL | MD | Pediatric Emergency Medicine (Pediatrics) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cook County | Current | Accepting new patients | |
| The University of Chicago Medical Center | Current | Accepting new patients | |
| The University of Chicago Medical Center | Current | Accepting new patients | |
| Cook County | Pediatrics | Current | Accepting new patients |
| Cook County | Current | Accepting new patients | |
| Child Health Foundation of Boston, Inc. | Pediatrics | Past | Accepting new patients |
| Children'S Hospital Pediatric Associates, Inc | Pediatrics | Past | Accepting new patients |
Locations
150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061
500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000
1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100
Interoperability endpoints
- amcqueenmd22413@uchospital.direct-ci.com
Organizations & group practices 7
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.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1588612832
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1033218128
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1831219450
-
- Community/Retail Pharmacy
- Calumet City, IL
- NPI 1255895678
-
- Pediatrics Physician
- Boston, MA
- NPI 1619969920
-
- Pediatrics Physician
- Boston, MA
- NPI 1457306664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1104865039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 HARVESTER DR",
"address_2": "SUITE 300",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605275919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371443",
"telephone_number": "888-824-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCQUEEN",
"first_name": "ALISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-06",
"last_updated": "2023-11-27",
"certification_date": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "IL",
"license": "036-121770",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036121770",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "amcqueenmd22413@uchospital.direct-ci.com",
"affiliation": "Y",
"affiliationName": "University of Chicago Physicians Group",
"address_1": "5841 S Maryland Ave",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606371443",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.