Individual provider Active NPI

Katie Cecilia Hall, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Chicago, IL
National Provider Identifier
1114424066
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036.158961 Issued in IL
Practice address
5841 S Maryland Ave # Mc6101
Chicago, IL 60637-1443
Phone
(773) 834-7708
NPI assigned
Apr 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036.158961 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave # Mc6101
Chicago, IL 60637-1443

Mailing address

150 Harvester Dr. Ste 300
Burr Ridge, IL 60527-6686
Phone (773) 702-1150

Other practice location 1

150 Harvester Dr Ste 300
Burr Ridge, IL 60527-5965
Phone (773) 702-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240619002633 AZ Practitioner - Pathology 1254687189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Indiana University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Dermatology PLLCGroup PAC ID 1557355385, 69 clinicians

Practice addresses (Care Compare)

6320 W Union Hills Dr
BLG a Suite 200
Glendale, AZ 85308-1061
Phone (480) 905-8485

Merit-based Incentive Payment System (MIPS)

Final score
83.48 of 100Reported as group
Quality
82.26
Promoting interoperability
83
Improvement activities
40
Cost
76.85

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Dermatology, PLLC CurrentSince Jul 12, 2024 Accepting new patients
Center for Dermatology, PLLC Past Accepting new patients
English Dermatology PC Past Accepting new patients

Locations

6320 W Union Hills Dr
Ste 200
Glendale, AZ 85308
Phone (480) 619-4097

6320 W Union Hills Dr
Ste A200
Glendale, AZ 85308

14275 N 87th St
Ste 110
Scottsdale, AZ 85260
Phone (480) 223-9501

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1523145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1114424066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR. STE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC6101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-834-7708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Harvester Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Burr Ridge",
            "state": "IL",
            "postal_code": "605275965",
            "country_code": "US",
            "telephone_number": "773-702-1150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "KATIE",
        "middle_name": "CECILIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-08",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036.158961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.