Individual provider Active NPI

Alexandria D Saulsberry, MD

  • Developmental - Behavioral Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1699869313
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
036121330 Issued in IL
Practice address
1801 W Taylor St
Suite 2E
Chicago, IL 60612-4795
Phone
(312) 996-7416
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036121330 IL
Developmental - Behavioral Pediatrics Physician 2080P0006X 036121330 IL Primary

Addresses

Primary practice location

1801 W Taylor St
Suite 2E
Chicago, IL 60612-4795

Mailing address

840 S Wood St
M/C 856
Chicago, IL 60612-4325
Phone (312) 413-5251

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
I20111027000166 IL Practitioner - Pediatric Medicine 8426221052 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036121330ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Jun 17, 2022 Accepting new patients
Cook County Pediatrics CurrentSince Jun 17, 2022 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Pediatrics CurrentSince Oct 1, 2011 Accepting new patients
Cook County Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Oct 1, 2011 Accepting new patients

Locations

1801 W Taylor St
Ste 2E
Chicago, IL 60612
Phone (312) 996-7416

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

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

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

Interoperability endpoints

  • Direct secure messaging: asaulsberry17440@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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1699869313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "address_2": "M/C 856",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-413-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST",
            "address_2": "SUITE 2E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124795",
            "telephone_number": "312-996-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAULSBERRY",
        "first_name": "ALEXANDRIA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036121330",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "IL",
            "license": "036121330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.