Individual provider Active NPI

Andrea E Rentea, MD

  • General Practice Physician
  • Chicago, IL
National Provider Identifier
1164599809
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
036058737 Issued in IL
Practice address
3525 West Peterson
Suite 611
Chicago, IL 60659
Phone
(773) 583-7793
Fax
(773) 583-7796
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 036058737 IL Primary

Addresses

Primary practice location

3525 West Peterson
Suite 611
Chicago, IL 60659

Mailing address

3525 West Peterson
Suite 611
Chicago, IL 60659
Phone (773) 583-7793

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
I20120127000993 IL Practitioner - General Practice 6103093893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Chicago College of Medicine and Surgery, 1975
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Paulina Med ClinicGroup PAC ID 4688841448, 2 clinicians

Practice addresses (Care Compare)

3525 W Peterson
Suite 611
Chicago, IL 60659-3318
Phone (773) 583-7793

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036058737ILMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paulina Med Clinic General Practice CurrentSince Jan 1, 1980 Accepting new patients

Locations

3525 W Peterson Ave
Ste 611
Chicago, IL 60659
Phone (312) 583-7793

Organizations & group practices 1

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 6

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1164599809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 WEST PETERSON",
            "address_2": "SUITE 611",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-583-7793",
            "fax_number": "773-583-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 WEST PETERSON",
            "address_2": "SUITE 611",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-583-7793",
            "fax_number": "773-583-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTEA",
        "first_name": "ANDREA",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036058737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.