Individual provider Active NPI

Bianca Felicia Rad, DO

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1417444084
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036157304 Issued in IL
Practice address
840 S Wood St
Chicago, IL 60612-4325
Phone
(312) 996-4150
NPI assigned
Apr 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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 036157304 IL Primary

Addresses

Primary practice location

840 S Wood St
Chicago, IL 60612-4325

Mailing address

6140 N Harding Ave
Chicago, IL 60659-3108
Phone (773) 592-9310

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
I20240801003477 IL Practitioner - Pediatric Medicine 6709132582 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Nov 14, 2024 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 Pediatrics CurrentSince Aug 16, 2024 Accepting new patients
Cook County Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Aug 16, 2024 Accepting new patients
Cook County Pediatrics CurrentSince Nov 14, 2024 Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

840 S Wood St
Chicago, IL 60612
Phone (312) 996-6711

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

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

Interoperability endpoints

  • Direct secure messaging: brad114727@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.

NPI Registry JSON

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1417444084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 N HARDING AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593108",
            "telephone_number": "773-592-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAD",
        "first_name": "BIANCA",
        "middle_name": "FELICIA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036157304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.