Individual provider Active NPI

Susan E Quaggin, MD

  • Nephrology Physician
  • Chicago, IL
National Provider Identifier
1164865408
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
336093221 Issued in IL
Practice address
303 E Superior St
Lurie 10-105
Chicago, IL 60611-3015
Phone
(312) 503-1531
Fax
(312) 503-6262
NPI assigned
Apr 16, 2013
Last updated
Apr 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 336093221 IL Primary

Addresses

Primary practice location

303 E Superior St
Lurie 10-105
Chicago, IL 60611-3015

Mailing address

303 E Superior St
Lurie 10-105
Chicago, IL 60611-3015
Phone (312) 503-1531

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
I20130502000391 IL Practitioner - NephrologyPractitioner - Internal Medicine 2668627043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

675 N St Clair
250 Dept of Nephrology
Chicago, IL 60611-5975
Phone (312) 695-0596

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
336093221ILMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Apr 15, 2013 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Apr 15, 2013 Accepting new patients

Locations

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

Dept 5777
Carol Stream, IL 60122

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

680 N Lake Shore Dr
Ste 1015
Chicago, IL 60611
Phone (312) 926-9674

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1164865408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E SUPERIOR ST",
            "address_2": "LURIE 10-105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113015",
            "telephone_number": "312-503-1531",
            "fax_number": "312-503-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E SUPERIOR ST",
            "address_2": "LURIE 10-105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113015",
            "telephone_number": "312-503-1531",
            "fax_number": "312-503-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAGGIN",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "336093221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.