Active NPI
Ruchi Mishra Fitzgerald, M.D.
- Addiction Medicine (Family Medicine) Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Family Medicine) Physician
- License
- 036150211
- Practice address
- 600 S Paulina St Ste 403
Chicago, IL 60612-3806 - Phone
- (312) 942-5000
- Fax
- (312) 942-5727
- NPI assigned
- Nov 14, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11751 | MT | |
| Surgery Physician | 208600000X | A94124 | CA | |
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 036150211 | IL | Primary |
Addresses
Primary practice location
600 S Paulina St Ste 403
Chicago, IL 60612-3806
Mailing address
600 S Paulina St Ste 403
Chicago, IL 60612-3806
Phone (312) 942-5000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Michigan Medical School, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14 Lake St
Oak Park, IL 60302-2606
Phone 7083830113220005
3 Erie CT
Suite 1300
Oak Park, IL 60302-2519
Phone (708) 406-3929
5425 W Lake St
Chicago, IL 60644-2342
Phone (773) 413-1920
5461 W Lake St
Chicago, IL 60644-2342
Phone 7083830113220005
Hospital & facility affiliations
- Macneal Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11751 | MT | MD | Family Medicine Physician |
| 036150211 | IL | MD | Addiction Medicine (Family Medicine) Physician |
| A94124 | CA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PCC Community Wellness Center | Current | Accepting new patients | |
| PCC Community Wellness Center | Current | Accepting new patients |
Locations
3 Erie Ct
#1300
Oak Park, IL 60302
Phone (708) 406-3929
3 Erie Ct
Ste 1300
Oak Park, IL 60302
Phone (708) 383-9786
14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113
Interoperability endpoints
- ruchi.fitzgerald.1@13158.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Oak Park, IL
- NPI 1871516799
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1134954506
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Berwyn, IL
- NPI 1295710580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566864000000",
"number": "1720060072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 S PAULINA ST STE 403",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123806",
"telephone_number": "312-942-5000",
"fax_number": "312-942-5727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 S PAULINA ST STE 403",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123806",
"telephone_number": "312-942-5000",
"fax_number": "312-942-5727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "RUCHI",
"middle_name": "MISHRA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-14",
"last_updated": "2019-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MT",
"license": "11751",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "A94124",
"primary": false
},
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "IL",
"license": "036150211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.