Individual provider Active NPI

Stacy Suzanne Brown, M.D.

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1366880908
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036.139462 Issued in IL
Practice address
5140 N California Ave Ste 635; 645
Chicago, IL 60625-3645
Phone
(773) 878-8200
Fax
(773) 878-0788
NPI assigned
Jun 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036.139462 IL Primary

Addresses

Primary practice location

5140 N California Ave Ste 635; 645
Chicago, IL 60625-3645

Mailing address

2740 W Foster Ave Ste 310
Chicago, IL 60625-3547
Phone (773) 878-8200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sbrown277094@direct.northshore.org

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
I20170814001991 IL Practitioner - Obstetrics/Gynecology 7810288347 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Boston University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

2739 W Foster Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

5140 N California Ave
Chicago, IL 60625-3664

5145 N California
Hosps Suite 331
Chicago, IL 60625-3661
Phone (847) 570-2280

5145 N California Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.139462ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Covenant Management Services, Inc. Obstetrics & Gynecology CurrentSince Sep 5, 2017 Accepting new patients
Endeavor Health Medical Group CurrentSince Jan 27, 2023 Accepting new patients
Obhg Illinois SC Obstetrics & Gynecology CurrentSince Jul 16, 2018 Accepting new patients
Endeavor Health Medical Group Obstetrics & Gynecology Current Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Sep 5, 2017 Accepting new patients

Locations

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

2740 W Foster Ave
Ste 310
Chicago, IL 60625

5140 N California Ave
Ste 635
Chicago, IL 60625
Phone (773) 907-3038

9532 Eagle Way
Chicago, IL 60678

5140 N California Ave
Chicago, IL 60625
Phone (773) 275-8811

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

Interoperability endpoints

  • Direct secure messaging: sbrown277094@direct.northshore.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1366880908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE STE 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253547",
            "telephone_number": "773-878-8200",
            "fax_number": "773-293-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 N CALIFORNIA AVE STE 635; 645",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253645",
            "telephone_number": "773-878-8200",
            "fax_number": "773-878-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "STACY",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-05",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036.139462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbrown277094@direct.northshore.org",
            "affiliation": "N",
            "address_1": "5140 N California Ave Ste 635; 645",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606253645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.