NPIMap

Organization Active NPI

Paragon Clinical LLC

  • Nurse Practitioner
  • Burr Ridge, IL
National Provider Identifier
1114139946
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
PARAGON CLINICAL LLC
Practice address
1333 Burr Ridge Pkwy Ste 200
Burr Ridge, IL 60527-0833
Phone
(630) 832-1775
Fax
(630) 832-3078
NPI assigned
May 4, 2007
Last updated
Apr 3, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Authorized official

Name
Dr. Marybeth E SutkowskiNPI 1447369293
Title
M.D. Ceo/Owner
Phone
(630) 605-4417

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

1333 Burr Ridge Pkwy Ste 200
Burr Ridge, IL 60527-0833

Mailing address

1333 Burr Ridge Pkwy Ste 200
Burr Ridge, IL 60527-0833
Phone (630) 832-1775

Other practice location 1

977 N Oaklawn Ave Ste 104
Elmhurst, IL 60126-1045
Phone (630) 832-1775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN, MI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20070515000051 IL Part B Supplier - Clinic/Group Practice 7214034925 Receives reassigned benefits from 186 practitioners
Practice locations: Burr Ridge, IL
O20150506001725 IN Part B Supplier - Clinic/Group Practice 7214034925 Receives reassigned benefits from 7 practitioners
Practice locations: Merrillville, IN; Hobard, IN; Dyer, IN; Chesterson, IN
O20170329002290 MI Part B Supplier - Clinic/Group Practice 7214034925 Receives reassigned benefits from 27 practitioners
Practice locations: Benton Harbor, MI

National Provider Directory

National Provider Directory

Locations

745 McClintock Dr
Ste 360
Burr Ridge, IL 60527
Phone (630) 506-1245

110 E Schiller St
Ste 318
Elmhurst, IL 60126

110 E Schiller St
Ste 319
Elmhurst, IL 60126
Phone (800) 530-5863

977 N Oaklawn Ave
Ste 104
Elmhurst, IL 60126
Phone (960) 832-1775

Practitioners & affiliated clinicians

Practitioners 268

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 268

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1114139946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 BURR RIDGE PKWY STE 200",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270833",
            "telephone_number": "630-832-1775",
            "fax_number": "630-832-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 BURR RIDGE PKWY STE 200",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270833",
            "telephone_number": "630-832-1775",
            "fax_number": "630-832-3078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "977 N Oaklawn Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "IL",
            "postal_code": "601261045",
            "country_code": "US",
            "telephone_number": "630-832-1775",
            "fax_number": "630-832-3078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PARAGON CLINICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "SUTKOWSKI",
        "authorized_official_first_name": "MARYBETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "M.D. CEO/OWNER",
        "authorized_official_telephone_number": "630-605-4417",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.