Individual provider Active NPI

Susan H Porto, M.D.

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1487643573
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036074744 Issued in IL
Practice address
2600 S Michigan Ave
305
Chicago, IL 60616-2857
Phone
(312) 326-4500
Fax
(312) 326-1200
NPI assigned
Oct 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036074744 IL Primary

Addresses

Primary practice location

2600 S Michigan Ave
305
Chicago, IL 60616-2857

Mailing address

2600 S Michigan Ave
305
Chicago, IL 60616-2857
Phone (312) 326-4500

Other identifiers 1

IdentifierTypeStateIssuer
036074744MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sporto107354@direct.luhs.org Direct LOYOLA UNIVERSITY MEDICAL CENTER

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
I20040322000328 IL Practitioner - Obstetrics/Gynecology 6608767645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loyola University of Chicago, Stritch School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians
Loyola Medical Group LLCGroup PAC ID 6305109547, 124 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

3722 Harlem Ave
Suite 204
Riverside, IL 60546-2320
Phone (708) 783-7840

Hospital & facility affiliations

  • Macneal Hospital Hospital, Berwyn, IL, CCN 140054
  • Loyola University Medical Center Hospital, Maywood, IL, CCN 140276

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Jun 1, 2021 Accepting new patients
Loyola Medical Group LLC CurrentSince May 1, 2018 Accepting new patients
Loyola University Medical Center CurrentSince Jun 1, 2021 Accepting new patients
Chicago Women'S Healthcare, SC Obstetrics & Gynecology Past Accepting new patients
Gottlieb Community Health Services Corporation PastSince Mar 1, 2018 Accepting new patients

Locations

3231 Euclid Ave
Ste 407
Berwyn, IL 60402
Phone (708) 783-7430

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

3722 Harlem Ave
Riverside, IL 60546
Phone (708) 442-0044

3722 Harlem Ave
Ste 204
Riverside, IL 60546
Phone (708) 749-0140

3722 Harlem Ave
Ste 101
Riverside, IL 60546
Phone (708) 783-6500

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

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 3

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1487643573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 S MICHIGAN AVE",
            "address_2": "305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162857",
            "telephone_number": "312-326-4500",
            "fax_number": "312-326-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S MICHIGAN AVE",
            "address_2": "305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162857",
            "telephone_number": "312-326-4500",
            "fax_number": "312-326-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTO",
        "first_name": "SUSAN",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036074744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036074744",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sporto107354@direct.luhs.org",
            "affiliation": "Y",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.