Individual provider Active NPI

Susan Miriam Fuchs, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Chicago, IL
National Provider Identifier
1205890613
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
036066939 Issued in IL
Practice address
225 E Chicago Ave # 62
Chicago, IL 60611
Phone
(312) 227-6647
Fax
(312) 227-9475
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 036066939 IL Primary

Addresses

Primary practice location

225 E Chicago Ave # 62
Chicago, IL 60611

Mailing address

225 E Chicago Ave # 62
Chicago, IL 60611-2991
Phone (312) 227-6647

Other identifiers 2

IdentifierTypeStateIssuer
F400389921OtherILPTAN
036066939MedicaidIL

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
I20040331000393 IL Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 5092707141 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lurie Children'S Medical Group Inc CurrentSince May 22, 2017 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 18, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 18, 2021 Accepting new patients
Pediatric Faculty Foundation, Inc Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

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

Claims Remittance
Carol Stream, IL 60122

225 E Chicago Ave
#62
Chicago, IL 60611
Phone (312) 227-6080

737 N Michigan Ave
Ste 2040
Chicago, IL 60611

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6415

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1205890613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE # 62",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-6647",
            "fax_number": "312-227-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE # 62",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-227-6647",
            "fax_number": "312-227-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUCHS",
        "first_name": "SUSAN",
        "middle_name": "MIRIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "IL",
            "license": "036066939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "F400389921",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036066939",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.