NPIMap

Individual provider Active NPI

Elizabeth Susan Davis, M.D,

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1407056526
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.141155 Issued in IL
Practice address
1700 W Van Buren St FL 5
Chicago, IL 60612-5500
Phone
(312) 563-2875
NPI assigned
Jul 18, 2007
Last updated
Apr 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A99450 CA
Internal Medicine Physician 207R00000X 036.141155 IL Primary

Addresses

Primary practice location

1700 W Van Buren St FL 5
Chicago, IL 60612-5500

Mailing address

1700 W Van Buren St FL 5
Chicago, IL 60612-5500
Phone (312) 573-2875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170322000165 IL Practitioner - Internal Medicine 3476615378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush Oak Park Physicians Group Elmwood ParkGroup PAC ID 9234393117, 6 clinicians
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 947-4663

7734 W N Ave
Elmwood Park, IL 60707-4124
Phone (708) 660-3900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
99450CAMDClinical Social Worker
A99450CAMDInternal Medicine Physician
036.141155ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Internal Medicine CurrentSince May 1, 2017 Accepting new patients
Rush Oak Park Physicians Group Elmwood Park CurrentSince Jul 1, 2025 Accepting new patients
City and County of San Francisco Past Accepting new patients

Locations

1700 W Van Buren St
#5
Chicago, IL 60612

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1700 W Van Buren St
Fl 5
Chicago, IL 60612
Phone (312) 563-2875

1700 W Van Buren St
Ste 500
Chicago, IL 60612
Phone (312) 563-2875

75 Remittance Dr
Dept 1611
Chicago, IL 60675

75 Remittance Dr
Ste 162
Chicago, IL 60675

7734 W North Ave
Elmwood Park, IL 60707
Phone (708) 456-6611

Interoperability endpoints

  • Direct secure messaging: edavis132236@direct.rush.rush-health.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1407056526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W VAN BUREN ST FL 5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606125500",
            "telephone_number": "312-573-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W VAN BUREN ST FL 5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606125500",
            "telephone_number": "312-563-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ELIZABETH",
        "middle_name": "SUSAN",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A99450",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.141155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.