Individual provider Active NPI

Sydney Doe, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1659826675
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125075806 Issued in IL
Practice address
251 E Huron St
Chicago, IL 60611-2908
Phone
(312) 503-7975
NPI assigned
Aug 19, 2016
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 125.075806 IL
Family Medicine Physician 207Q00000X 125075806 IL Primary

Addresses

Primary practice location

251 E Huron St
Chicago, IL 60611-2908

Mailing address

251 E Huron St
Chicago, IL 60611-2908
Phone (312) 503-7975

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
I20231108002213 IL Practitioner - Family Practice 8022431386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northwestern University Feinberg Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Esperanza Health CentersGroup PAC ID 2961453105, 53 clinicians

Practice addresses (Care Compare)

4700 S California Ave
Chicago, IL 60632-2016
Phone (773) 584-6200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125075806ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Esperanza Health Centers CurrentSince Sep 30, 2023 Accepting new patients
Esperanza Health Centers CurrentSince Sep 30, 2023 Accepting new patients
Esperanza Health Centers Past Accepting new patients

Locations

2001 S California Ave
Chicago, IL 60608
Phone (773) 484-1201

2001 S California Ave
Ste 100
Chicago, IL 60608
Phone (773) 640-5785

4700 S California Ave
Chicago, IL 60632
Phone (708) 713-0078

6550 S Richmond St
Chicago, IL 60629
Phone (773) 309-4445

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11903/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sydney.doe.1@11903.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1659826675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-503-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-503-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOE",
        "first_name": "SYDNEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-19",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.075806",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125075806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.