Individual provider Active NPI

Colleen Marie Badke, MD/MPH

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1356683809
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036.140090 Issued in IL
Practice address
225 E Chicago Ave
Box 18
Chicago, IL 60611-2991
Phone
(312) 227-3220
NPI assigned
Mar 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 036.140090 IL Primary

Addresses

Primary practice location

225 E Chicago Ave
Box 18
Chicago, IL 60611-2991

Mailing address

225 E Chicago Ave
Box 18
Chicago, IL 60611-2991
Phone (312) 227-3220

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
I20230307001923 IL Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 4486027737 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.140090ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lurie Children'S Medical Group Inc Pediatrics CurrentSince Nov 19, 2022 Accepting new patients

Locations

Claims Remittance
Carol Stream, IL 60122

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6415

225 E Chicago Ave
#18
Chicago, IL 60611
Phone (312) 227-3220

225 E Chicago Ave
#118
Chicago, IL 60611

Organizations & group practices 1

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": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1356683809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "address_2": "BOX 18",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "address_2": "BOX 18",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADKE",
        "first_name": "COLLEEN",
        "middle_name": "MARIE",
        "credential": "MD/MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-22",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.140090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.