NPIMap

Individual provider Active NPI

Adrienne M. Edge, MD

  • Pediatrics Physician
  • Algonquin, IL
National Provider Identifier
1639458128
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036101735 Issued in IL
Practice address
2971 W Algonquin Rd
Suite 105
Algonquin, IL 60102-9406
Phone
(847) 854-5490
Fax
(847) 854-8257
NPI assigned
Aug 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036101735 IL Primary

Addresses

Primary practice location

2971 W Algonquin Rd
Suite 105
Algonquin, IL 60102-9406

Mailing address

2971 W Algonquin Rd
Suite 105
Algonquin, IL 60102-9406
Phone (847) 854-5490

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address aedge288314@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036101735ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Pediatrics SC Pediatrics Past Accepting new patients
Neelam Narula MD Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aedge288314@direct.myadvocateaurora.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1639458128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2971 W ALGONQUIN RD",
            "address_2": "SUITE 105",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601029406",
            "telephone_number": "847-854-5490",
            "fax_number": "847-854-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2971 W ALGONQUIN RD",
            "address_2": "SUITE 105",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601029406",
            "telephone_number": "847-854-5490",
            "fax_number": "847-854-8257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGE",
        "first_name": "ADRIENNE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-15",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036101735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aedge288314@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2971 W Algonquin Rd",
            "address_2": "Suite 105",
            "city": "Algonquin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601029406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2971 W Algonquin Rd",
            "address_2": "Suite 105",
            "city": "Algonquin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601029406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Algonquin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.