Individual provider Active NPI

Sally Ann Campbell-Lee, M.D.

  • Clinical Pathology Physician
  • Chicago, IL
National Provider Identifier
1669430773
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
License
036-117084 Issued in IL
Practice address
1740 W Taylor St
University of Illinois at Chicago Hospital Room 3138
Chicago, IL 60612-7232
Phone
(312) 996-1350
NPI assigned
May 1, 2006
Last updated
Jul 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 036117084 IL
Blood Banking & Transfusion Medicine Physician 207ZB0001X 036117084 IL
Clinical Pathology Physician 207ZC0006X 036-117084 IL Primary

Addresses

Primary practice location

1740 W Taylor St
University of Illinois at Chicago Hospital Room 3138
Chicago, IL 60612-7232

Mailing address

840 S Wood St
MC 847 Room 130 CSN Uic Dept of Pathology
Chicago, IL 60612-4325
Phone (312) 996-1350

Other identifiers 1

IdentifierTypeStateIssuer
412330100MedicaidMD

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
I20070206000142 IL Practitioner - PathologyPractitioner - Other (Physician) 3274535158 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Albany Medical College of Union University, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1740 W Taylor St
Mc693
Chicago, IL 60612-7232
Phone (312) 355-2759

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036117084ILMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Aug 1, 2008 Accepting new patients
The Board of Trustees of the University of Illinois Blood Banking & Transfusion Medicine CurrentSince Aug 1, 2008 Accepting new patients
Jackson Park Hospital Foundation Current Accepting new patients
Cook County Current Accepting new patients
Cook County Family Medicine CurrentSince Jun 16, 2015 Accepting new patients
Cook County CurrentSince Jun 16, 2015 Accepting new patients

Locations

1740 W Taylor St
#693
Chicago, IL 60612
Phone (312) 355-2759

1740 W Taylor St
Rm 3138
Chicago, IL 60612
Phone (312) 996-1350

1819 W Polk St
Chicago, IL 60612
Phone (312) 996-6604

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

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

840 S Wood St
Rm 130
Chicago, IL 60612
Phone (312) 996-1641

Interoperability endpoints

  • Direct secure messaging: sallycampbell-lee@jph.medalliesdirect.net
  • Direct secure messaging: scampbelllee10958@uihealth.direct-ci.com

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.

Hospital & facility affiliations 1

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1669430773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "address_2": "MC 847 ROOM 130 CSN UIC DEPT OF PATHOLOGY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "address_2": "UNIVERSITY OF ILLINOIS AT CHICAGO HOSPITAL ROOM 3138",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "312-996-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL-LEE",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "IL",
            "license": "036117084",
            "primary": false
        },
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "IL",
            "license": "036117084",
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "IL",
            "license": "036-117084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "412330100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.