Individual provider Active NPI

Anna Gutina Smith, M.D.

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Park Ridge, IL
National Provider Identifier
1649631540
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
036148476 Issued in IL
Practice address
1775 Dempster St
Park Ridge, IL 60068-1143
Phone
(847) 723-5150
NPI assigned
Mar 19, 2016
Last updated
Sep 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 036148476 IL Primary
Pediatrics Physician 208000000X 036148476 IL

Addresses

Primary practice location

1775 Dempster St
Park Ridge, IL 60068-1143

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-4000

Other practice location 2

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-4000

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address asmith344044@direct.myadvocateaurora.org Direct

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
I20220720003579 IL Practitioner - Pediatric Medicine 6800189515 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036148476ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Aug 16, 2022 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 1, 2022 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 1, 2022 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Board of Trustees of the University of Illinois CurrentSince Aug 16, 2022 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

1740 W Taylor St
#931
Chicago, IL 60612
Phone (312) 355-5258

29373 Network Pl
Chicago, IL 60673

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

Interoperability endpoints

  • Direct secure messaging: asmith344044@direct.myadvocateaurora.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1458345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1649631540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 DEMPSTER ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681143",
            "telephone_number": "847-723-5150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 E Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "312-227-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 E Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "312-227-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANNA",
        "middle_name": "GUTINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-19",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "IL",
            "license": "036148476",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036148476",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asmith344044@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.