NPIMap

Individual provider Active NPI

Patricia Vassallo, MD

  • Cardiovascular Disease Physician
  • Chicago, IL
National Provider Identifier
1205053998
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036108456 Issued in IL
Practice address
675 N Saint Clair St Ste 1900
Chicago, IL 60611-5975
Phone
(312) 695-4965
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036108456 IL Primary

Addresses

Primary practice location

675 N Saint Clair St Ste 1900
Chicago, IL 60611-5975

Mailing address

676 N Saint Clair St Ste 600
Chicago, IL 60611-2981
Phone (312) 695-4965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 1, 2026 through Oct 1, 2028

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070801000564 IL Practitioner - Cardiovascular Disease (Cardiology) 7810088184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Georgetown University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

680 N Lake Shire Dr
Suite 1000
Chicago, IL 60611-8709

680 N Lake Shore Dr
Suite 1000
Chicago, IL 60611-3062

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2007 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2007 Accepting new patients
Central Dupage Physician Group PastSince Jan 26, 2020 Accepting new patients

Locations

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

Dept 5777
Carol Stream, IL 60122

1333 W Belmont Ave
Ste 200
Chicago, IL 60657
Phone (773) 248-5009

676 N Saint Clair St
Ste 600
Chicago, IL 60611
Phone (312) 664-3278

675 N Saint Clair St
Ste 19-100
Chicago, IL 60611
Phone (312) 664-3278

675 N Saint Clair St
Ste 1900
Chicago, IL 60611

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

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1205053998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112981",
            "telephone_number": "312-695-4965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 1900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115975",
            "telephone_number": "312-695-4965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSALLO",
        "first_name": "PATRICIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036108456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.