Individual provider Active NPI

Linda Anne Palumbo, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1215994264
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-090435 Issued in IL
Practice address
40 W 75TH Street
Chicago, IL 60527
Phone
(630) 581-5372
Fax
(630) 568-3247
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-090435 IL Primary

Addresses

Primary practice location

40 W 75TH Street
Chicago, IL 60527

Mailing address

40 W 75TH Street
Chicago, IL 60527
Phone (630) 581-5372

Other identifiers 1

IdentifierTypeStateIssuer
036090435MedicaidIL

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
I20050419000192 IL Practitioner - Family Practice 7012955362 Reassigns benefits to 1 organization
Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 2, IncGroup PAC ID 0547495467, 221 clinicians

Practice addresses (Care Compare)

40 75TH St
Willowbrook, IL 60527-2325
Phone (630) 581-5372

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-090435ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Dec 1, 2013 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Dec 1, 2013 Accepting new patients
Northwestern Memorial Physicians Group Internal Medicine Past Accepting new patients

Locations

12200 Western Ave
Ste 100
Blue Island, IL 60406
Phone (708) 631-2781

2868 N Broadway St
Chicago, IL 60657
Phone (773) 569-3525

1190 S Naper Blvd
Naperville, IL 60540
Phone (312) 229-0345

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1215994264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W 75TH STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60527",
            "telephone_number": "630-581-5372",
            "fax_number": "630-568-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 W 75TH STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60527",
            "telephone_number": "630-581-5372",
            "fax_number": "630-568-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALUMBO",
        "first_name": "LINDA",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-090435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090435",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.