Individual provider Active NPI

Claudia Cheryl Boucher-Berry, M.D.

  • Pediatric Endocrinology Physician
  • Chicago, IL
National Provider Identifier
1437383528
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
036126838 Issued in IL
Practice address
840 S Wood St # Mc856
Department of Pediatric Endocrinology
Chicago, IL 60612-4325
Phone
(312) 996-1795
Fax
(312) 996-8218
NPI assigned
May 5, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036126838 IL
Pediatric Endocrinology Physician 2080P0205X 245144 NY
Pediatric Endocrinology Physician 2080P0205X 036126838 IL Primary

Addresses

Primary practice location

840 S Wood St # Mc856
Department of Pediatric Endocrinology
Chicago, IL 60612-4325

Mailing address

840 S Wood St # Mc856
Department of Pediatric Endocrinology
Chicago, IL 60612-4325
Phone (312) 996-1795

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
I20110117000151 IL Practitioner - Pediatric Medicine 2264621630 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
State University of New York Downstate Medical Center, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1801 W Taylor St
Chicago, IL 60612-4795

840 S Wood St
Chicago, IL 60612-4325

840 S Wood St 130 CSN
Uic Pathology
Chicago, IL 60612-4325
Phone (312) 996-7313

840 S Wood St MC
Chicago, IL 60612-4325

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036126838ILMDPediatrics Physician
245144NYMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jan 17, 2011 Accepting new patients
Cook County CurrentSince Jan 20, 2022 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Cook County Pediatrics CurrentSince Jan 20, 2022 Accepting new patients
Cook County Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jan 17, 2011 Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients
Board of Trustees of the University of Illinois Pediatrics Past Accepting new patients

Locations

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

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700

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

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

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

1740 W Taylor St
Ste 1400
Chicago, IL 60612
Phone (312) 996-3900

Interoperability endpoints

  • Direct secure messaging: cboucherberry16906@uihealth.direct-ci.com

Organizations & group practices 8

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": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1437383528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST # MC856",
            "address_2": "DEPARTMENT OF PEDIATRIC ENDOCRINOLOGY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-1795",
            "fax_number": "312-996-8218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST # MC856",
            "address_2": "DEPARTMENT OF PEDIATRIC ENDOCRINOLOGY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-1795",
            "fax_number": "312-996-8218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER-BERRY",
        "first_name": "CLAUDIA",
        "middle_name": "CHERYL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036126838",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "245144",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "IL",
            "license": "036126838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.