Individual provider Active NPI

Jacqueline Leavitt, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1144332768
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-096995 Issued in IL
Practice address
1700 W Van Buren St
Suite 500
Chicago, IL 60612-3218
Phone
(312) 563-2875
Fax
(312) 942-3012
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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 036-096995 IL Primary

Addresses

Primary practice location

1700 W Van Buren St
Suite 500
Chicago, IL 60612-3218

Mailing address

1700 W Van Buren St
Suite 500
Chicago, IL 60612-3218
Phone (312) 563-2875

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
I20100819000867 IL Practitioner - Internal Medicine 1456485960 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rush Medical College of Rush University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (888) 824-0200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-096995ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Jul 31, 2023 Accepting new patients
University of Chicago CurrentSince Jul 31, 2023 Accepting new patients
Rush University Medical Group Internal Medicine CurrentSince Jul 1, 1998 Accepting new patients
The University of Chicago Medical Center CurrentSince Jul 31, 2023 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

1725 W Harrison St
Ste 10
Chicago, IL 60612
Phone (312) 563-3700

75 Remittance Dr
Dept 1611
Chicago, IL 60675

539 N Dearborn St
Chicago, IL 60654
Phone (312) 549-4400

47 W Polk St
Ste G1
Chicago, IL 60605
Phone (312) 567-6700

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1700 W Van Buren St
Ste 500
Chicago, IL 60612
Phone (312) 563-2875

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: jleavitt275449@uchospital.direct-ci.com
  • Direct secure messaging: jleavittmd625@direct.rush.rush-health.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1144332768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W VAN BUREN ST",
            "address_2": "SUITE 500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123218",
            "telephone_number": "312-563-2875",
            "fax_number": "312-942-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W VAN BUREN ST",
            "address_2": "SUITE 500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123218",
            "telephone_number": "312-563-2875",
            "fax_number": "312-942-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "JACQUELINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-096995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.