Individual provider Active NPI

Nicole Thompson, M.D.

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1497890990
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036116562 Issued in IL
Practice address
1740 W Taylor St
Dept 3452
Chicago, IL 60612-7232
Phone
(312) 704-2885
Fax
(312) 704-2737
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036116562 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Dept 3452
Chicago, IL 60612-7232

Mailing address

1105 Beloit Ave
Forest Park, IL 60130-2305
Phone (708) 606-5129

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
I20070525000136 IL Practitioner - Anesthesiology 8921105941 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Loyola University of Chicago, Stritch School of Medicine, 2001
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, 1,134 clinicians

Practice addresses (Care Compare)

1740 W Taylor St
Chicago, IL 60612-7232

1801 W Taylor St
Chicago, IL 60612-4795

1855 W Taylor St
Chicago, IL 60612-7242
Phone (312) 996-6590

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Board of Trustees of the University of Illinois Anesthesiology CurrentSince May 24, 2010 Accepting new patients
Shriners Hospitals for Children CurrentSince Jul 16, 2013 Accepting new patients
Shriners Hospitals for Children CurrentSince Jul 16, 2013 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince May 24, 2010 Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

1740 W Taylor St
#3452
Chicago, IL 60612
Phone (312) 704-2885

801 S Paulina St
#621
Chicago, IL 60612
Phone (312) 355-1661

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

2211 N Oak Park Ave
Chicago, IL 60707
Phone (773) 385-5463

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

7732 Solutions Ctr
Chicago, IL 60677

1740 W Taylor St
#3200
Chicago, IL 60612
Phone (312) 996-4021

Organizations & group practices 6

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497890990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 BELOIT AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302305",
            "telephone_number": "708-606-5129",
            "fax_number": "708-366-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "address_2": "DEPT 3452",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "312-704-2885",
            "fax_number": "312-704-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036116562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.