Individual provider Active NPI

Cathy A Divincenzo, MD

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1407852817
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036099031 Issued in IL
Practice address
6374 N Lincoln Ave Ste 204
Chicago, IL 60659-1219
Phone
(872) 270-5999
NPI assigned
Jun 22, 2005
Last updated
May 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036099031 IL Primary

Addresses

Primary practice location

6374 N Lincoln Ave Ste 204
Chicago, IL 60659-1219

Mailing address

6374 N Lincoln Ave Ste 204
Chicago, IL 60659-1219
Phone (872) 270-5999

Other identifiers 1

IdentifierTypeStateIssuer
036099031MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cdivincenzo252279@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20240531002908 IL Practitioner - Family Practice 7517309891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rush Medical College of Rush University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Refuah Health CenterGroup PAC ID 5193103653, 12 clinicians

Practice addresses (Care Compare)

6374 N Lincoln Ave
Chicago, IL 60659-1275
Phone (872) 270-5999

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036099031ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Refuah Health Center Pediatrics CurrentSince May 4, 2025 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince May 21, 2024 Accepting new patients
Midwest Refuah Health Center CurrentSince Feb 3, 2025 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince May 21, 2024 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

6374 N Lincoln Ave
Chicago, IL 60659
Phone (872) 208-3095

6374 N Lincoln Ave
Ste 204
Chicago, IL 60659
Phone (312) 539-8142

6557 N Lincoln Ave
Lincolnwood, IL 60712
Phone (773) 337-6994

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCEHCD

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

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1407852817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6374 N LINCOLN AVE STE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591219",
            "telephone_number": "872-270-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6374 N LINCOLN AVE STE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591219",
            "telephone_number": "872-270-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVINCENZO",
        "first_name": "CATHY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036099031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099031",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdivincenzo252279@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1675 Dempster St Fl 2",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1675 Dempster St Fl 2",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.