Organization Active NPI

Susan J Accardi MD LTD

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1174786255
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036054322 Issued in IL
Legal business name
SUSAN J ACCARDI MD LTD
Practice address
25 E Washington St
Suite 1464
Chicago, IL 60602-1708
Phone
(312) 855-0208
Fax
(312) 230-0300
NPI assigned
Jul 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Authorized official

Name
Susan J Accardi, M D
Title
President
Phone
(312) 855-0208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 036054322 IL Primary

Addresses

Primary practice location

25 E Washington St
Suite 1464
Chicago, IL 60602-1708

Mailing address

25 E Washington St
Suite 1464
Chicago, IL 60602-1708
Phone (312) 855-0208

Other identifiers 2

IdentifierTypeStateIssuer
0021607345OtherILBLUE CROSS
036054322MedicaidIL

National Provider Directory

National Provider Directory

Locations

25 E Washington St
Ste 1464
Chicago, IL 60602
Phone (312) 600-7818

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386633600000",
    "number": "1174786255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST",
            "address_2": "SUITE 1464",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021708",
            "telephone_number": "312-855-0208",
            "fax_number": "312-230-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST",
            "address_2": "SUITE 1464",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021708",
            "telephone_number": "312-855-0208",
            "fax_number": "312-230-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN J ACCARDI MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2013-12-10",
        "status": "A",
        "authorized_official_last_name": "ACCARDI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-855-0208",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036054322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0021607345",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036054322",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.