Individual provider Active NPI

Sydney W Schneidman, MD, FACEP, FCEM

  • Emergency Medicine Physician
  • Evanston, IL
National Provider Identifier
1679730766
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036119428 Issued in IL
Practice address
1704 Maple Ave # 100
Evanston, IL 60201-3134
Phone
(312) 694-2014
NPI assigned
May 18, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD070799L PA
Emergency Medicine Physician 207P00000X 036119428 IL Primary

Addresses

Primary practice location

1704 Maple Ave # 100
Evanston, IL 60201-3134

Mailing address

680 N Lake Shore Dr Ste 1000
Chicago, IL 60611-8709
Phone (312) 695-0665

Other identifiers 1

IdentifierTypeStateIssuer
8600645MedicaidWA

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
I20111004000104 IL Practitioner - Emergency Medicine 2466624077 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mass Medical SCGroup PAC ID 4082848460, 5 clinicians

Practice addresses (Care Compare)

1025 W Everett Rd
Suite 101
Lake Forest, IL 60045-2697
Phone (847) 234-7950

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
MD070799LPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
App of Illinois Ed PLLC Emergency Medicine CurrentSince Nov 22, 2016 Accepting new patients
Mass Medical, S.C. CurrentSince Jun 1, 2016 Accepting new patients
Central Dupage Physician Group PastSince Jun 1, 2016 Accepting new patients
Ideas Unlimited Inc Past Accepting new patients

Locations

1025 W Everett Rd
Ste 101
Lake Forest, IL 60045
Phone (847) 234-7950

1050 Red Oak Ln
Lindenhurst, IL 60046
Phone (847) 356-4700

1324 N Sheridan Rd
Waukegan, IL 60085
Phone (847) 360-3000

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1211068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1679730766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR STE 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606118709",
            "telephone_number": "312-695-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 MAPLE AVE # 100",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013134",
            "telephone_number": "312-694-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDMAN",
        "first_name": "SYDNEY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD, FACEP, FCEM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-18",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD070799L",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036119428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8600645",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.