Sally Louise Reynolds, MD

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

036071339 Issued in IL

Practice address

Department of Emergency Medicine
225 East Chicago Avenue
Chicago, IL 60611

Phone

(800) 543-7362

Fax

(312) 227-9475

NPI assigned

Mar 20, 2006

Last updated

May 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Lurie Children's Medical Group Inc

  dba LCMG Inc

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1518064716
  Medicare reassignment
• Pediatric Anesthesia Associates, LTD

  • Anesthesiology Physician
  • Chicago, IL
  • NPI 1891721775
  NPD (past)
• Pediatric Faculty Foundation, Inc

  dba PFF Emergency Services

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Chicago, IL
  • NPI 1124123146
  NPD (past)

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1417916362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF EMERGENCY MEDICINE",
            "address_2": "225 EAST CHICAGO AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "800-543-7362",
            "fax_number": "312-227-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF EMERGENCY MEDICINE",
            "address_2": "225 EAST CHICAGO AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "800-543-7362",
            "fax_number": "312-227-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "SALLY",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "IL",
            "license": "036071339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036071339",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith Abbie Reynolds, MD
• Nancy Reynolds, OT
• Natasha L Reynolds, PSY.D.
• Rachel Elizabeth Reynolds, DPT
• Racquel Reynolds
• Sarah Helen Reynolds
• Virginia Reynolds, LCPC 180 007 760
• Edgar Manuel Reynoso Vanderhorst, M.D.
• Christopher Jesus Reynoso
• Diego Paul Reynoso, M.D.

• Pediatric Emergency Medicine (Pediatrics) Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.