Suzanne Chan, DNP,FNP-BC, PMHNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

277000615 Issued in IL

Practice address

3201 S Wallace St
Chicago, IL 60616-3501

Phone

(312) 248-8610

Fax

(312) 728-7582

NPI assigned

Dec 7, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Suzanne Siu Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score

97.34 of 100Reported as group

Quality

96.26

Improvement activities

40

Cost

62.79

Merit-based Incentive Payment System (MIPS)

Final score

81.04 of 100Reported as group

Quality

53.2

Promoting interoperability

89

Improvement activities

40

Cost

76.1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FABEDD/Endpoint/FABEDD

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.

• Integrative Primary Care and Mental Health Clinic, LLC

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1154187433

  IL, Multi-Specialty

  Medicare reassignment NPD Authorized official
• Lifeline Physicians LLC

  • Internal Medicine Physician
  • Lake Forest, IL
  • NPI 1841907839

  IL, Multi-Specialty

  Medicare reassignment NPD
• Medico PLLC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1225613219

  IL, Multi-Specialty

  Medicare reassignment NPD

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

• Central Dupage Hospital Association

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810

  Hospital

  Care Compare affiliation
• Central Dupage Hospital Association

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1497299689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 S WALLACE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163501",
            "telephone_number": "312-975-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 S WALLACE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163501",
            "telephone_number": "312-248-8610",
            "fax_number": "312-728-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SUZANNE",
        "credential": "DNP,FNP-BC, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277000615",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277000615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1154187433",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "SIU",
            "credential": "DNP,FNP-BC, PMHNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samson Chan, MD
• Sery Chan
• Shu B. Chan, M.D.
• Shu Yen Chan
• Susan Ae Chan, LPC
• Tom Chan, D.D.S
• Vanessa Chan
• Victor Wai Yuen Chan, D.O.
• Wallace Chan, O.D.
• Yui Y Chan, M.D.

• All providers in Chicago, IL
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.