Organization Active NPI

Ronald J Vasu MD SC

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1407876832
Registry record updated May 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036039369 Issued in IL
Legal business name
RONALD J VASU MD SC
Practice address
233 E Erie St
Suite 605
Chicago, IL 60611-2926
Phone
(312) 642-2434
NPI assigned
Jul 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2013

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

Authorized official

Name
Dr. Ronald J Vasu, M.D.NPI 1558381970
Title
President
Phone
(312) 642-2434

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 036039369 IL Primary

Addresses

Primary practice location

233 E Erie St
Suite 605
Chicago, IL 60611-2926

Mailing address

233 E Erie St
Suite 605
Chicago, IL 60611-2926
Phone (312) 642-2434

Other identifiers 2

IdentifierTypeStateIssuer
036039369MedicaidIL
210716OtherILWPS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050110000937 IL Part B Supplier - Clinic/Group Practice 8729036355 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL; Evanston, IL

National Provider Directory

National Provider Directory

Locations

233 E Erie St
Ste 605
Chicago, IL 60611
Phone (312) 642-2434

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369699200000",
    "number": "1407876832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 E ERIE ST",
            "address_2": "SUITE 605",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112926",
            "telephone_number": "312-642-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E ERIE ST",
            "address_2": "SUITE 605",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112926",
            "telephone_number": "312-642-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD J VASU MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-05-28",
        "status": "A",
        "authorized_official_last_name": "VASU",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-642-2434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036039369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036039369",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS",
            "identifier": "210716",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.