Northside Rheumatology PLLC

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

Legal business name

NORTHSIDE RHEUMATOLOGY PLLC

Practice address

1945 W Wilson Ave Ste 100
Chicago, IL 60640-7927

Phone

(773) 769-9040

Fax

(847) 866-8990

NPI assigned

Dec 5, 2022

Last updated

Aug 26, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Noelle Miller

Title

Director of RCM

Phone

(248) 331-7908

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Heartland Alliance Health

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1538294483

  Member Of

  NPD member

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Manish Jain, M.D.

  • Rheumatology Physician
  • Chicago, IL
  • NPI 1417075581
  Medicare reassignment NPD
• Cory L Conniff, MD

  • Rheumatology Physician
  • Orland Park, IL
  • NPI 1376539726
  Medicare reassignment
• Deanna B. S. Martin, PA-C

  • Medical Physician Assistant
  • Chicago, IL
  • NPI 1790193423
  Medicare reassignment
• Shanmugam Mukundan, M.D.

  • Internal Medicine Physician
  • Sun City, AZ
  • NPI 1730191610
  NPD

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787702400000",
    "number": "1437860061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779335",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770438",
            "fax_number": "847-866-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 W WILSON AVE STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407927",
            "telephone_number": "773-769-9040",
            "fax_number": "847-866-8990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 W Irving Park Rd",
            "address_purpose": "LOCATION",
            "city": "Streamwood",
            "state": "IL",
            "postal_code": "601072851",
            "country_code": "US",
            "telephone_number": "773-769-9040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1603 Orrington Ave Ste 600",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602013860",
            "country_code": "US",
            "telephone_number": "773-769-9040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHSIDE RHEUMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-05",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "NOELLE",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "248-331-7908"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "1945 W Wilson Ave Ste 100",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606407927",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "403 W Irving Park Rd",
            "city": "Streamwood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601072851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Northside Neonatal and Infant Care SC
• Northside Neurosurgery, LLC
• Northside Physical Therapy
• Northside Physical Therapy
• Northside Psychology Services PLLC
• Northside Speech Solutions P.C.
• Northside Wellness Center LTD
• Northside-Suburban Pediatric Associates, S.C.
• Northstar Pediatrics Inc.
• Northstar Restorative Counseling LLC

• Rheumatology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Rheumatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.