Individual provider Active NPI

Theodora Vamvouris, MD

  • Hospitalist Physician
  • Chicago, IL
National Provider Identifier
1770937161
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036157462 Issued in IL
Practice address
676 N Saint Clair St Ste 600
Chicago, IL 60611-2981
Phone
(312) 664-3278
Fax
(312) 695-0063
NPI assigned
Apr 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 63646 CT
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 036157462 IL Primary

Addresses

Primary practice location

676 N Saint Clair St Ste 600
Chicago, IL 60611-2981

Mailing address

676 N Saint Clair St Ste 600
Chicago, IL 60611-2981
Phone (312) 664-3278

Other practice location 1

30 Shelburne Rd
Stamford, CT 06902-3628
Phone (203) 276-7147

Other practice location 2

20 York Street, CB-329
New Haven, CT 06510-3220
Phone (203) 688-1734

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210924000781 IL Practitioner - Hospitalist 0941534762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036157462ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2021 Accepting new patients
Central Dupage Physician Group Hospitalist PastSince Oct 31, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

676 N Saint Clair St
Ste 600
Chicago, IL 60611
Phone (312) 664-3278

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

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 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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1770937161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112981",
            "telephone_number": "312-664-3278",
            "fax_number": "312-695-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112981",
            "telephone_number": "312-664-3278",
            "fax_number": "312-695-0063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Shelburne Rd",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069023628",
            "country_code": "US",
            "telephone_number": "203-276-7147",
            "fax_number": "203-276-7368",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 York Street, CB-329",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-1734",
            "fax_number": "203-688-9638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAMVOURIS",
        "first_name": "THEODORA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "63646",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036157462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.