Individual provider Active NPI

Andrew R Vissing, MD

  • Nephrology Physician
  • Chicago, IL
National Provider Identifier
1265961593
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036.155824 Issued in IL
Practice address
251 E Huron St
Chicago, IL 60611-2908
Phone
(312) 926-2000
NPI assigned
Jun 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125-070360 IL
Pediatrics Physician 208000000X 125-070360 IL
Pediatric Nephrology Physician 2080P0210X 036.155824 IL
Nephrology Physician 207RN0300X 036.155824 IL Primary

Addresses

Primary practice location

251 E Huron St
Chicago, IL 60611-2908

Mailing address

251 E Huron St
Chicago, IL 60611-2908

Other practice location 1

675 N Saint Clair St Ste 18-250
Chicago, IL 60611-5980
Phone (312) 926-4880

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
I20250418001056 IL Practitioner - NephrologyPractitioner - Internal Medicine 2062782303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Indiana University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

675 N St Clair
250 Dept of Nephrology
Chicago, IL 60611-5975
Phone (312) 695-0596

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.155824ILMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jun 1, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 1, 2025 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

675 N Saint Clair St
Ste 18-250
Chicago, IL 60611
Phone (312) 695-8624

251 E Huron St
Chicago, IL 60611

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Interoperability endpoints

  • Direct secure messaging: andrew.vissing.1@3547.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1265961593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-926-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 N Saint Clair St Ste 18-250",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606115980",
            "country_code": "US",
            "telephone_number": "312-926-4880",
            "fax_number": "312-926-4878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VISSING",
        "first_name": "ANDREW",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-09",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125-070360",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125-070360",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "IL",
            "license": "036.155824",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036.155824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.