Individual provider Active NPI

Farzaneh Aghdassi Sorond, MD PHD

  • Neurocritical Care Physician
  • Chicago, IL
National Provider Identifier
1366409831
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
License
036.138715 Issued in IL
Practice address
710 N Lake Shore Dr
Suite 1116
Chicago, IL 60611-3006
Phone
(312) 503-3963
Fax
(312) 503-3950
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036138715 IL
Neurocritical Care Physician 2084A2900X 036.138715 IL Primary

Addresses

Primary practice location

710 N Lake Shore Dr
Suite 1116
Chicago, IL 60611-3006

Mailing address

680 N Lake Shore Dr
Suite# 1000
Chicago, IL 60611-4546
Phone (312) 695-9797

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
I20150728005691 IL Practitioner - NeurologyPractitioner - Critical Care (Intensivists) 8628266954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.138715ILMDNeurocritical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2015 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2015 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1366409831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE# 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-695-9797",
            "fax_number": "312-695-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N LAKE SHORE DR",
            "address_2": "SUITE 1116",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113006",
            "telephone_number": "312-503-3963",
            "fax_number": "312-503-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOROND",
        "first_name": "FARZANEH",
        "middle_name": "AGHDASSI",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036138715",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "IL",
            "license": "036.138715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.