Active NPI
Susan M Nedza, M.D.
- Emergency Medicine Physician
- Chicago, IL
National Provider Identifier
1275536419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036-071513
- Practice address
- 8600 W. Bryn Mawr Ave
Suite 800
Chicago, IL 60631 - Phone
- (773) 864-4764
- NPI assigned
- May 23, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036-071513 | IL | Primary |
Addresses
Primary practice location
8600 W. Bryn Mawr Ave
Suite 800
Chicago, IL 60631
Mailing address
812 S Clay St
Hinsdale, IL 60521-4541
Phone (630) 655-3835
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-071513 | IL | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364947200000",
"number": "1275536419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "812 S CLAY ST",
"city": "HINSDALE",
"state": "IL",
"postal_code": "605214541",
"telephone_number": "630-655-3835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8600 W. BRYN MAWR AVE",
"address_2": "SUITE 800",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60631",
"telephone_number": "773-864-4764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEDZA",
"first_name": "SUSAN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-05-23",
"last_updated": "2013-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036-071513",
"primary": true
}
],
"identifiers": [],
"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 Apr 3, 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.