Individual provider Active NPI

Paul Pickering, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1407973183
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036102715 Issued in IL
Practice address
1111 E 87TH St
Suite 900
Chicago, IL 60619-7038
Phone
(773) 702-2900
Fax
(773) 702-2277
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036102715 IL Primary

Addresses

Primary practice location

1111 E 87TH St
Suite 900
Chicago, IL 60619-7038

Mailing address

180 Harvester Dr
Suite 110
Burr Ridge, IL 60527-5993
Phone (773) 834-1061

Other identifiers 1

IdentifierTypeStateIssuer
036102715MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2025 through Jan 1, 2027

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036102715ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Memorial Physicians Group Internal Medicine Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1407973183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR",
            "address_2": "SUITE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275993",
            "telephone_number": "773-834-1061",
            "fax_number": "773-834-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E 87TH ST",
            "address_2": "SUITE 900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606197038",
            "telephone_number": "773-702-2900",
            "fax_number": "773-702-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKERING",
        "first_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036102715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036102715",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.