Individual provider Active NPI

Ann E Bidwell, MD

  • Ophthalmology Physician
  • Chicago, IL
National Provider Identifier
1144296823
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036072393 Issued in IL
Practice address
259 E Erie St Ste 1520
Chicago, IL 60611-3111
Phone
(312) 695-8150
Fax
(312) 695-3652
NPI assigned
Feb 23, 2006
Last updated
Apr 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 079589 GA
Ophthalmology Physician 207W00000X 036072393 IL Primary

Addresses

Primary practice location

259 E Erie St Ste 1520
Chicago, IL 60611-3111

Mailing address

259 E Erie St Ste 1520
Chicago, IL 60611-3111
Phone (312) 695-8150

Other practice location 1

675 N Saint Clair St
Galter 15-150
Chicago, IL 60611-5975
Phone (312) 695-8150

Other practice location 2

675 N Saint Clair St
Galter 15-150
Chicago, IL 60611-5975
Phone (312) 695-8150

Other practice location 3

2070 Pleasant Hill Rd Ste 100
Duluth, GA 30096-4659
Phone (770) 622-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180703001898 GA Practitioner - Ophthalmology 2365579539 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Hope Eye Center, LLC CurrentSince Jan 20, 2018 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

2070 Pleasant Hill Rd
Ste 100
Duluth, GA 30096
Phone (770) 622-2020

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1144296823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 1520",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113111",
            "telephone_number": "312-695-8150",
            "fax_number": "312-695-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 1520",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113111",
            "telephone_number": "312-695-8150",
            "fax_number": "312-695-3652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 N Saint Clair St",
            "address_2": "GALTER 15-150",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606115975",
            "country_code": "US",
            "telephone_number": "312-695-8150",
            "fax_number": "312-503-8152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "675 N Saint Clair St",
            "address_2": "GALTER 15-150",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606115975",
            "country_code": "US",
            "telephone_number": "312-695-8150",
            "fax_number": "312-503-8152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2070 Pleasant Hill Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300964659",
            "country_code": "US",
            "telephone_number": "770-622-2020",
            "fax_number": "770-622-2021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIDWELL",
        "first_name": "ANN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "079589",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036072393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.