NPIMap

Individual provider Active NPI

Susan Ignatius, MD

  • Internal Medicine Physician
  • Carol Stream, IL
National Provider Identifier
1649374935
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036090377 Issued in IL
Practice address
501 Thornhill Dr
Carol Stream, IL 60188-2793
Phone
(630) 668-3210
Fax
(630) 668-3505
NPI assigned
Sep 8, 2006
Last updated
Oct 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036090377 IL Primary

Addresses

Primary practice location

501 Thornhill Dr
Carol Stream, IL 60188-2793

Mailing address

501 Thornhill Dr
Carol Stream, IL 60188-2793
Phone (630) 668-3210

Other identifiers 3

IdentifierTypeStateIssuer
920540OtherILMEDICARE GROUP PTAN
F400137406OtherILMEDICARE INDIVIDUAL PTAN
036090377MedicaidIL

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
I20100713000343 IL Practitioner - Internal Medicine 7911092226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rush Medical College of Rush University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

517 Thornhill Dr
Carol Stream, IL 60188-2703
Phone (630) 668-3210

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036090377ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Internal Medicine CurrentSince Jun 1, 2014 Accepting new patients
Dupage Internal Medicine, LTD. Internal Medicine Current Accepting new patients
Central Dupage Physician Group CurrentSince Jun 1, 2014 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

501 Thornhill Dr
Carol Stream, IL 60188
Phone (630) 653-1918

517 Thornhill Dr
Carol Stream, IL 60188
Phone (630) 668-3210

Dept 5777
Carol Stream, IL 60122

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Interoperability endpoints

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

Organizations & group practices 3

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.

Hospital & facility affiliations 12

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": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1649374935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 THORNHILL DR",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601882793",
            "telephone_number": "630-668-3210",
            "fax_number": "630-668-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 THORNHILL DR",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601882793",
            "telephone_number": "630-668-3210",
            "fax_number": "630-668-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGNATIUS",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036090377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "920540",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "F400137406",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090377",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carol Stream, IL

Sources for this page

Verify at the official NPI Registry.