Susan Barclay, MD
Individual provider Active NPI Pediatrics Physician · South Holland, IL
NPI 1144206145 · NPPES record last updated Dec 16, 2021
Key facts
- NPI
- 1144206145
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 036090785 (IL)
- Practice address
- 100 W 162ND St
South Holland, IL 60473-2003 - Phone
- (708) 730-2200
- Fax
- (708) 210-0621
- NPI assigned
- Dec 21, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040701000856 | IL | Practitioner - Pediatric Medicine | 6800873407 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036090785 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health and Hospitals Corporation | Current |
Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current |
Accepting new patients |
Locations
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
29373 Network Pl
Chicago, IL 60673
100 W 162nd St
South Holland, IL 60473
Phone (708) 730-2200
Interoperability endpoints
- sbarclay319645@direct.myadvocateaurora.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036090785 | IL | Yes |
Addresses
Primary practice location
100 W 162ND St
South Holland, IL 60473-2003
Mailing address
100 W 162ND St
South Holland, IL 60473-2003
Phone (708) 730-2200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01621679 | Other | IL | BCBS OF IL |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sbarclay319645@direct.myadvocateaurora.org | Direct | |
| FHIR URL | sbarclay319645@direct.myadvocateaurora.org |
Other providers in South Holland, IL
- Awesome Star Enterprise Inc
- B.O.O.C. Inc.
- Ellamonique Baccus
- Sameera Baig
- Candyce Banks
- Kimberly Barr
- Chirayu Baxi
- Irene M Benson
- Bethshan Association
- Beverly Hadley, DDS P.C.
All providers in South Holland, IL · Pediatrics Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.