Individual provider Active NPI

Nathan Joseph Stackhouse, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1487097838
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036140205 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Apr 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036140205 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

1919 W Taylor St
Chicago, IL 60612-7246
Phone (312) 355-1706

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
I20160912000365 IL Practitioner - Family Practice 6305146556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Univ of Illinois at Chicago College of Dentistry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, shared by 24 NPIs, 1,134 clinicians

Practice addresses (Care Compare)

1740 W Taylor St
Chicago, IL 60612-7232
Phone (312) 413-3282

1919 W Taylor St
Mc663
Chicago, IL 60612-7246
Phone (312) 996-0750

Hospital & facility affiliations

  • University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036140205ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Apr 29, 2022 Accepting new patients
The Board of Trustees of the University of Illinois Family Medicine CurrentSince Aug 7, 2016 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Aug 7, 2016 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients

Locations

722 W Maxwell St
#235
Chicago, IL 60607
Phone (312) 433-4114

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

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

8131 S May St
Chicago, IL 60620
Phone (312) 365-5801

1220 S Wood St
Chicago, IL 60608
Phone (312) 413-1261

7702 Solution Ctr
Chicago, IL 60677

1919 W Taylor St
#663
Chicago, IL 60612
Phone (312) 996-0750

7732 Solution Ctr
Dept 3461
Chicago, IL 60677

1919 W Taylor St
Chicago, IL 60612
Phone (312) 996-2901

7732 Solutions Ctr
Chicago, IL 60677

Interoperability endpoints

  • Direct secure messaging: nstackhouse17500@uihealth.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509494400000",
    "number": "1487097838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127246",
            "telephone_number": "312-355-1706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACKHOUSE",
        "first_name": "NATHAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-15",
        "last_updated": "2017-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036140205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.