Individual provider Active NPI

Jennifer Lynn Ennis, M.D.

  • Nephrology Physician
  • Chicago, IL
National Provider Identifier
1376707364
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036-113891 Issued in IL
Practice address
1801 W Taylor St
Suite #3D
Chicago, IL 60612-4795
Phone
(312) 355-1700
NPI assigned
Jul 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 036-113891 IL Primary

Addresses

Primary practice location

1801 W Taylor St
Suite #3D
Chicago, IL 60612-4795

Mailing address

2250 W Campbell Park Dr
Chicago, IL 60612-3502
Phone (312) 243-0600

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
I20100331000078 IL Practitioner - NephrologyPractitioner - Internal Medicine 5890821623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Pittsburgh School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

1740 W Taylor St
Chicago, IL 60612-7232

1801 W Taylor St
Chicago, IL 60612-4795

1855 W Taylor St
Chicago, IL 60612-7242
Phone (312) 996-6590

Hospital & facility affiliations

  • University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-113891ILMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Feb 27, 2010 Accepting new patients
The Board of Trustees of the University of Illinois Nephrology CurrentSince Feb 27, 2010 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients
Litholink Corporation Past Accepting new patients
Litholink Corporation Past Accepting new patients

Locations

7732 Solutions Ctr
Chicago, IL 60677

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

1801 W Taylor St
Ste 3D
Chicago, IL 60612
Phone (312) 355-1700

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

1740 W Taylor St
Ste 1400
Chicago, IL 60612
Phone (312) 996-3900

Interoperability endpoints

  • Direct secure messaging: jennis17014@uihealth.direct-ci.com

Organizations & group practices 6

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 1

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": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1376707364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 W CAMPBELL PARK DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123502",
            "telephone_number": "312-243-0600",
            "fax_number": "312-243-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST",
            "address_2": "SUITE #3D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124795",
            "telephone_number": "312-355-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036-113891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.