Active NPI
Gunilla Sigrid Carlsson Thorn, M.D.
- Dermatology Physician
- St Charles, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- AN52403945287
- Practice address
- 2900 Foxfield Rd
St Charles, IL 60174-5799 - Phone
- (630) 315-6500
- Fax
- (630) 615-6519
- NPI assigned
- Aug 14, 2008
- Last updated
- Aug 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | AN52403945287 | IL | Primary |
| Internal Medicine Physician | 207R00000X | AN52403945287 | IL |
Addresses
Primary practice location
2900 Foxfield Rd
St Charles, IL 60174-5799
Mailing address
2900 Foxfield Rd
St Charles, IL 60174-5799
Phone (630) 315-6500
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CA4748 | Other | IL | MEDICARE RR (GROUP) |
| 036132093 | Medicaid | IL | |
| 206147 | Other | IL | MEDICARE (GROUP) |
| F400094850 | Other | IL | MEDICARE (INDIVIDUAL) |
| P01324606 | Other | IL | MEDICARE RR (INDIVIDUAL) |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Northwestern University Feinberg Medical School, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800
25 N Winfield Rd
Winfield, IL 60190-1295
2900 Foxfield Rd
St Charles, IL 60174-5799
636 Raymond Dr
Suite 204
Naperville, IL 60563-9791
Phone (630) 682-8700
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.63 of 100
- Quality
- 88.47
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 295 |
| Removal or shaving of skin growth | 70 |
| Skin biopsy | 122 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AN52403945287 | IL | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Physician Group | Internal Medicine | Current | Accepting new patients |
| Central Dupage Physician Group | Current | Accepting new patients |
Locations
Carol Stream, IL 60122
Phone (630) 933-3300
Dept 5777
Carol Stream, IL 60122
2900 Foxfield Rd
St Charles, IL 60174
Phone (630) 377-7900
2900 Foxfield Rd
Ste 101
St Charles, IL 60174
Phone (630) 513-8275
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600
Organizations & group practices 2
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.
-
dba Northwestern Medicine Regional Medical Group
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
Internal Medicine
-
dba Northwestern Medicine Regional Medical Group
- Orthopaedic Surgery Physician
- Geneva, IL
- NPI 1780012344
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Northwestern Medicine Central Dupage Hospital
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
-
dba Northwestern Medicine Central Dupage Hospital
- Psychiatric Hospital Unit
- Winfield, IL
- NPI 1740230895
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407715200000",
"number": "1174779755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 FOXFIELD RD",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601745799",
"telephone_number": "630-315-6500",
"fax_number": "630-615-6519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 FOXFIELD RD",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601745799",
"telephone_number": "630-315-6500",
"fax_number": "630-615-6519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSSON THORN",
"first_name": "GUNILLA",
"middle_name": "SIGRID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-14",
"last_updated": "2014-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IL",
"license": "AN52403945287",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "AN52403945287",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR (GROUP)",
"identifier": "CA4748",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036132093",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE (GROUP)",
"identifier": "206147",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE (INDIVIDUAL)",
"identifier": "F400094850",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR (INDIVIDUAL)",
"identifier": "P01324606",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Charles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.