Individual provider Active NPI

Susan E Nelson, M.D.

  • Internal Medicine Physician
  • Buffalo Grove, IL
National Provider Identifier
1144208612
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036076434 Issued in IL
Practice address
15 S McHenry Rd
Buffalo Grove, IL 60089-6705
Phone
(847) 618-0351
Fax
(847) 618-0766
NPI assigned
Jan 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036076434 IL Primary

Addresses

Primary practice location

15 S McHenry Rd
Buffalo Grove, IL 60089-6705

Mailing address

15 S McHenry Rd
Buffalo Grove, IL 60089-6705
Phone (847) 618-0351

Other identifiers 1

IdentifierTypeStateIssuer
36076434MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address snelson23540@direct.nch.org

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050520000851 IL Practitioner - Internal Medicine 4284675083 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1200 W Algonquin Rd
Palatine, IL 60067-7373
Phone (847) 618-0535

1450 Busch Pkwy
Buffalo Grove, IL 60089-4541
Phone (847) 725-8640

15 S McHenry Rd
Buffalo Grove, IL 60089-6705
Phone (847) 520-9424

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Community Health Services Inc CurrentSince Sep 1, 2010 Accepting new patients
Northwest Community Health Services Inc Internal Medicine CurrentSince Sep 1, 2010 Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Nov 7, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 7, 2023 Accepting new patients
Rand Imaging Center Past Accepting new patients

Locations

1538 N Arlington Heights Rd
Arlington Heights, IL 60004
Phone (847) 253-6464

1051 W Rand Rd
Arlington Hts, IL 60004
Phone (847) 221-4601

1450 Busch Pkwy
Buffalo Grove, IL 60089
Phone (847) 459-7860

15 S McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-6100

15 S McHenry Rd
Fl 2
Buffalo Grove, IL 60089
Phone (847) 439-8780

1450 Busch Pkwy
Ste 100
Buffalo Grove, IL 60089
Phone (847) 459-7860

1450 Busch Pkwy
#100
Buffalo Grove, IL 60089
Phone (847) 459-7860

25233 Network Pl
Chicago, IL 60673

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1144208612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S MCHENRY RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896705",
            "telephone_number": "847-618-0351",
            "fax_number": "847-618-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S MCHENRY RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896705",
            "telephone_number": "847-618-0351",
            "fax_number": "847-618-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SUSAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036076434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36076434",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "snelson23540@direct.nch.org",
            "affiliation": "N",
            "address_1": "1450 Busch Pkwy # 100",
            "city": "Buffalo Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600894541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.