Individual provider Active NPI

James W Schroeder II, MD

  • Pediatric Otolaryngology Physician
  • Chicago, IL
National Provider Identifier
1134147382
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
036108913 Issued in IL
Practice address
225 E. Chicago Ave., #25
Ann & Robert H. Lurie Children'S Hospital of Chicago
Chicago, IL 60611-2605
Phone
(312) 227-6230
Fax
(312) 227-9414
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 036108913 IL Primary

Addresses

Primary practice location

225 E. Chicago Ave., #25
Ann & Robert H. Lurie Children'S Hospital of Chicago
Chicago, IL 60611-2605

Mailing address

225 E. Chicago Ave., #25
Ann & Robert H. Lurie Children'S Hospital of Chicago
Chicago, IL 60611-2605
Phone (312) 227-6230

Other identifiers 3

IdentifierTypeStateIssuer
036108913 1MedicaidIL
036-108913OtherILLICENSE
1627123OtherILBCBS PROVIDER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lurie Children'S Medical Group, LLC Past Accepting new patients

Organizations & group practices 1

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1134147382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E. CHICAGO AVE., #25",
            "address_2": "ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112605",
            "telephone_number": "312-227-6230",
            "fax_number": "312-227-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E. CHICAGO AVE., #25",
            "address_2": "ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112605",
            "telephone_number": "312-227-6230",
            "fax_number": "312-227-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "JAMES",
        "middle_name": "W",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "IL",
            "license": "036108913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108913 1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "036-108913",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "1627123",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "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 Apr 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.