Susan M Ichelle Fanapour, D.O.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036105985 Issued in IL

Practice address

120 N. Oak Street
Hinsdale, IL 60521

Phone

(630) 856-9000

NPI assigned

Aug 2, 2005

Last updated

Jul 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Diagnostic Radiology

Education

Midwestern University, Chicago College of Osteopathic Med, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suburban Radiologists, S.C.Group PAC ID 0648248328, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uchicago Medicine Adventhealth la Grange Hospital, La Grange, IL, CCN 140065
• Uchicago Medicine Adventhealth Hinsdale Hospital, Hinsdale, IL, CCN 140122
• Uchicago Medicine Adventhealth Bolingbrook Hospital, Bolingbrook, IL, CCN 140304
• Uchicago Medicine Adventhealth Glenoaks Hospital, Glendale Heights, IL, CCN 140292

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Suburban Radiologists, S.C.

  • Diagnostic Radiology Physician
  • La Grange, IL
  • NPI 1386665396
  Medicare reassignment Care Compare group NPD
• Associated Imaging Specialists

  • Diagnostic Radiology Physician
  • Elgin, IL
  • NPI 1366493256
  Medicare reassignment NPD

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

• Adventist Bolingbrook Hospital

  dba Adventhealth Bolingbrook

  • General Acute Care Hospital
  • Bolingbrook, IL
  • NPI 1164530465
  Care Compare affiliation
• Adventist Glenoaks Hospital

  dba Adventhealth Glenoaks

  • Psychiatric Hospital Unit
  • Glendale Heights, IL
  • NPI 1477572949
  Care Compare affiliation
• Adventist Glenoaks Hospital

  dba Adventhealth Glenoaks

  • General Acute Care Hospital
  • Glendale Heights, IL
  • NPI 1760415939
  Care Compare affiliation
• Adventist Midwest Health

  • General Acute Care Hospital
  • Hinsdale, IL
  • NPI 1265465439
  Care Compare affiliation
• Adventist Midwest Health

  dba Adventhealth la Grange

  • General Acute Care Hospital
  • La Grange, IL
  • NPI 1407889652
  Care Compare affiliation
• Adventist Midwest Health

  dba Adventhealth Hinsdale

  • Psychiatric Hospital Unit
  • Hinsdale, IL
  • NPI 1447270780
  Care Compare affiliation
• Adventist Midwest Health

  dba Adventhealth la Grange

  • Rehabilitation Hospital Unit
  • La Grange, IL
  • NPI 1588068274
  Care Compare affiliation

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1568463586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 HARGER RD STE 408",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231818",
            "telephone_number": "630-472-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N. OAK STREET",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "60521",
            "telephone_number": "630-856-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANAPOUR",
        "first_name": "SUSAN",
        "middle_name": "M ICHELLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036105985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francis R Facchini, MD
• Marc Ruffino Fajardo, MD
• Jodi A Faley, LCSW
• Family Dental Hinsdale (Kapur Dental Hinsdale)
• Family Health Care, S.C.
• Betty Fang, PHARMD, BCACP
• Marissa Fang, ED.S
• Sharon Fang, MD
• Sara Smiley Farrero, M.A.
• Fatima Jaffer MD SC

• Diagnostic Radiology Physician in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.