Individual provider Active NPI

Maura Dickinson

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1154645604
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036135376 Issued in IL
Practice address
1501 S California Ave
Chicago, IL 60608-1732
Phone
(773) 542-2000
NPI assigned
Mar 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036135376 IL Primary
Emergency Medicine Physician 207P00000X 02005313A IN
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1501 S California Ave
Chicago, IL 60608-1732

Mailing address

26460 Network PL
Chicago, IL 60673-1264
Phone (773) 257-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20180504000306 IN Practitioner - Emergency Medicine 3971735606 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 836-1600

Hospital & facility affiliations

  • Community Hospital Hospital, Munster, IN, CCN 150125

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036135376ILMDEmergency Medicine Physician
02005313AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Feb 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Community Care Network Inc CurrentSince Apr 1, 2018 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Feb 1, 2022 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

9660 Wicker Ave
Saint John, IN 46373
Phone (219) 226-2203

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

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": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1154645604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26460 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731264",
            "telephone_number": "773-257-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081732",
            "telephone_number": "773-542-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "MAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036135376",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02005313A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.