NPIMap

Individual provider Active NPI

Rebecca M Grundy, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1528607967
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.007280 Issued in IL
Practice address
4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone
(773) 388-1600
NPI assigned
Jan 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.007280 IL Primary

Addresses

Primary practice location

4025 N Sheridan Rd
Chicago, IL 60613-2010

Mailing address

4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone (773) 388-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200304001474 IL Practitioner - Physician Assistant 6608203690 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

4800 W Chicago Ave
Chicago, IL 60651-3226
Phone (773) 826-9600

500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.007280ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Jun 22, 2023 Accepting new patients
Howard Brown Health Center CurrentSince Feb 1, 2020 Accepting new patients
Cook County CurrentSince Jun 22, 2023 Accepting new patients
Howard Brown Health Center CurrentSince Feb 1, 2020 Accepting new patients
Howard Brown Health Center Past Accepting new patients
Howard Brown Health Center Past Accepting new patients
John H Stroger Jr Hospital Cook County Past Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800

Organizations & group practices 8

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 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1528607967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132010",
            "telephone_number": "773-388-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132010",
            "telephone_number": "773-388-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNDY",
        "first_name": "REBECCA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.007280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.