Susan S Anderson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036086995 Issued in IL

Practice address

5225 Old Orchard Rd Ste 27a
Skokie, IL 60077-1027

Phone

(847) 975-2921

Fax

(847) 501-2921

NPI assigned

Nov 15, 2006

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 23, 2023 through Feb 23, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sanderson21504@direct.northshore.org

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.

• Dupage Psychiatric Care PLLC

  • Psychiatry Physician
  • Oak Park, IL
  • NPI 1801465695
  NPD (past)
• Rangsons Healthcare, PLLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Hinsdale, IL
  • NPI 1144716457
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1346312261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 OLD ORCHARD RD STE 27A",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771027",
            "telephone_number": "847-975-2921",
            "fax_number": "847-501-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 OLD ORCHARD RD STE 27A",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771027",
            "telephone_number": "847-975-2921",
            "fax_number": "847-501-2921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9933 Lawler Ave",
            "address_2": "Suite 325",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "60077",
            "country_code": "US",
            "telephone_number": "847-674-2500",
            "fax_number": "847-674-2509",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2650 Ridge Ave",
            "address_2": "Dept of Psychiatry",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602011700",
            "country_code": "US",
            "telephone_number": "847-570-2540",
            "fax_number": "847-733-5247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SUSAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036086995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001606486",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sanderson21504@direct.northshore.org",
            "affiliation": "N",
            "address_1": "2650 Ridge Ave",
            "address_2": "Dept of Psychiatry",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "602011700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amys ABA Therapy Services
• Yesenia Anaya, PTA
• Devon Anderson, PA-C
• Kay W Anderson, OTR L
• Michael Vincent Anderson, APN
• Damiana Andonova
• Mary Catherine Andreoni, MSN,NP-C,CDE
• Amanda L. Andrews, PA-C
• Binoy Andrews
• Lyndal Diane Andrews, MA, LCSW

• Psychiatry Physician in Skokie, IL
• Providers in Skokie, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.