Individual provider Active NPI

Andreas Skoubis, D.O.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1164499406
Registry record updated Oct 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-103126 Issued in IL
Practice address
1653 W Congress Pkwy
Suite 177
Chicago, IL 60612-3833
Phone
(312) 942-8149
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-103126 IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy
Suite 177
Chicago, IL 60612-3833

Mailing address

1653 W Congress Pkwy
Suite 177
Chicago, IL 60612-3833
Phone (312) 942-8149

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
I20050412000242 IL Practitioner - Emergency Medicine 0749227742 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Emergency Physicians PCGroup PAC ID 5597763706, 37 clinicians

Practice addresses (Care Compare)

25 N Winfield Rd
Winfield, IL 60190-1222
Phone (630) 933-2640

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-103126ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Dec 10, 2010 Accepting new patients
Central Dupage Emergency Physicians, PC Emergency Medicine CurrentSince Mar 1, 2012 Accepting new patients
Cook County Current Accepting new patients
Cook County Emergency Medicine CurrentSince Dec 10, 2010 Accepting new patients
Rush University Medical Center Emergency Medicine Current Accepting new patients
Valley Emergency Care Management, Inc. Emergency Medicine CurrentSince Oct 1, 2020 Accepting new patients
Rush University Medical Center Current Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1653 W Congress Pkwy
#177
Chicago, IL 60612
Phone (312) 947-0229

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1653 W Congress Pkwy
Ste 177
Chicago, IL 60612
Phone (312) 942-4978

300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 7

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 3

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255046400000",
    "number": "1164499406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "address_2": "SUITE 177",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-8149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "address_2": "SUITE 177",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-8149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOUBIS",
        "first_name": "ANDREAS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2009-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-103126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.