NPIMap

Individual provider Active NPI

Senda Ajroud-Driss, MD

  • Neuromuscular Medicine (Psychiatry & Neurology) Physician
  • Chicago, IL
National Provider Identifier
1164412557
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromuscular Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084N0008X
License
036108764 Issued in IL
Practice address
259 E Erie St Ste 1900
Chicago, IL 60611-3246
Phone
(312) 695-7950
Fax
(312) 695-5747
NPI assigned
Oct 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036108764 IL
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X 036108764 IL Primary

Addresses

Primary practice location

259 E Erie St Ste 1900
Chicago, IL 60611-3246

Mailing address

259 E Erie St Ste 1900
Chicago, IL 60611-3246
Phone (312) 695-7950

Other practice location 1

680 N Lake Shore Dr
Suite 1000
Chicago, IL 60611-4546
Phone (312) 695-4022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050926000516 IL Practitioner - NeuropsychiatryPractitioner - Neurology 8224062567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeuropsychiatryAlso: Neurology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

259 E Erie St
Suite 1900
Chicago, IL 60611-3246
Phone (312) 695-7950

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036108764ILMDNeuromuscular Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Aug 15, 2005 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 15, 2005 Accepting new patients
University of Chicago Past Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

259 E Erie St
Ste 1900
Chicago, IL 60611

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

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 8

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1164412557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 1900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113246",
            "telephone_number": "312-695-7950",
            "fax_number": "312-695-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 1900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113246",
            "telephone_number": "312-695-7950",
            "fax_number": "312-695-5747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 N Lake Shore Dr",
            "address_2": "SUITE 1000",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606114546",
            "country_code": "US",
            "telephone_number": "312-695-4022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AJROUD-DRISS",
        "first_name": "SENDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036108764",
            "primary": false
        },
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "IL",
            "license": "036108764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.