Susan Bardolph, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036.144202 Issued in IL

Practice address

1121 South Blvd
Oak Park, IL 60302-2812

Phone

(708) 745-5744

Fax

(630) 456-7486

NPI assigned

Apr 3, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

Specialty

HospitalistAlso: Internal Medicine

Education

Michigan State University College of Human Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Residential Home Health Home health agency, Lisle, IL, CCN 147568
• Advocate Home Health Care Serv Home health agency, Oakbrook, IL, CCN 147150
• Astra Health Home health agency, Harwood Heights, IL, CCN 148259
• Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200
• Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sbardolph171047@dulyhealthandcare.direct-ci.com

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.

• Dupage Medical Group LTD

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  Medicare reassignment Care Compare group NPD
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Downers Grove, IL
  • NPI 1578670543
  Care Compare affiliation
• Cardinal Homehealth Inc

  • Home Health Agency
  • Harwood Heights, IL
  • NPI 1518108703
  Care Compare affiliation
• Ehs Home Health Care Service Inc

  • Home Health Agency
  • Oak Brook, IL
  • NPI 1598732075
  Care Compare affiliation
• Elmhurst Memorial Hospital

  • General Acute Care Hospital
  • Elmhurst, IL
  • NPI 1548306343
  Care Compare affiliation
• Residential Home Health Illinois, LLC

  • Home Health Agency
  • Lisle, IL
  • NPI 1336377365
  Care Compare affiliation

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1740608058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 SOUTH BLVD",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022812",
            "telephone_number": "708-745-5744",
            "fax_number": "630-456-7486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDOLPH",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125065525",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.144202",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036144202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "susan.bardolph@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "25 N Winfield Rd Ste 400",
            "city": "Winfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601901222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bharath Banothu
• James P Baraglia, M.D.
• Emilia N Barajas, LSW
• Thomas Lawrence Baranowski, DDS
• Blair Winn Barbour, MSW ACSW LCSW
• Stephanie Barker, DNP, APRN, CPNP-PC
• Chandra Y Barnes
• Dejohn Anthony Barnes, MA LPC
• Ruqayyah Barnes
• Mary Barnett

• Internal Medicine Physician in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.

Verify at the official NPI Registry.