Nicole M. Colucci, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036102891 Issued in IL

Practice address

5645 W Addison St
Our Lady of the Resurrection Hospital
Chicago, IL 60634-4403

Phone

(773) 282-7000

Fax

(773) 794-7664

NPI assigned

Jul 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Emergency MedicineAlso: Internal Medicine

Education

Midwestern University, Chicago College of Osteopathic Med, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dupage Emergency Physicians LTDGroup PAC ID 6507854288, 27 clinicians

Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117
• Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1912283110

  Emergency Medicine, IL

  Medicare reassignment Care Compare group NPD
• Dupage Emergency Physicians LTD

  • Emergency Medicine Physician
  • Downers Grove, IL
  • NPI 1255323481

  IL

  Medicare reassignment Care Compare group
• Dupage Emergency Physicians Convenient Care LLC

  • Emergency Medicine Physician
  • Lemont, IL
  • NPI 1922000363

  Emergency Medicine, IL

  Medicare reassignment NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1518415751

  Emergency Medicine

  NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Springfield, IL
  • NPI 1871360297

  Emergency Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Downers Grove, IL
  • NPI 1578670543

  Hospital

  Care Compare affiliation
• Resurrection Medical Center - Chicago LLC

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1811735228

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1295735017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 22ND ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486110",
            "telephone_number": "630-874-2542",
            "fax_number": "630-874-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 W ADDISON ST",
            "address_2": "OUR LADY OF THE RESURRECTION HOSPITAL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344403",
            "telephone_number": "773-282-7000",
            "fax_number": "773-794-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLUCCI",
        "first_name": "NICOLE",
        "middle_name": "M.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036102891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colorful Minds ABA
• Breanna Lynn Colorina, FNP-C
• Anne Coltman, MS, RD, CNSCN
• Jacob Colton, LCSW
• Katharine Rose Colton, M.D.
• Columbia Furniture
• Columbus Manor
• Shamel Colvard
• Colvel Labs Inc.
• Colville Counseling, LLC

• All providers in Chicago, IL
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.