Active NPI
Souleymane Diallo, DPM
- Foot & Ankle Surgery Podiatrist
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 135.001086
- Practice address
- 4646 N Marine Dr
Chicago, IL 60640-5759 - Phone
- (773) 878-8700
- NPI assigned
- Jun 6, 2020
- Last updated
- Jul 27, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 135.001086 | IL | Primary |
Addresses
Primary practice location
4646 N Marine Dr
Chicago, IL 60640-5759
Mailing address
4646 N Marine Dr
Chicago, IL 60640-5759
Phone (773) 878-8700
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | chicago |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- R Franklin University of Med & Sci/Chicago Medical School, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2653 W Ogden Ave
FL 3 Suite a
Chicago, IL 60608-1647
Phone (773) 257-6672
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.03 of 100
- Quality
- 71.53
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.89
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 20 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 37 |
| Removal or shaving of skin growth | 15 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 135.001086 | IL | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Sinai Community Foundation | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Current | Accepting new patients |
Locations
2701 W 68th St
Chicago, IL 60629
Phone (773) 471-8000
2653 W Ogden Ave
Chicago, IL 60608
Phone (773) 257-6672
4646 N Marine Dr
Chicago, IL 60640
Phone (773) 564-5102
26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900
2653 W Ogden Ave
Fl 3
Chicago, IL 60608
Phone (773) 257-6701
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Sinai Medical Group
- Rehabilitation Hospital
- Chicago, IL
- NPI 1376715896
-
dba Sinai Medical Group
- Radiation Oncology Physician
- Chicago, IL
- NPI 1578601209
-
dba Sinai Medical Group
- General Acute Care Hospital
- Chicago, IL
- NPI 1982657854
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Chicago, IL
- NPI 1427547538
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1962425611
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1871581314
-
- Rehabilitation Hospital Unit
- Chicago, IL
- NPI 1023006566
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595808000000",
"number": "1831713676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4646 N MARINE DR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606405759",
"telephone_number": "773-878-8700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4646 N MARINE DR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606405759",
"telephone_number": "773-878-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIALLO",
"first_name": "SOULEYMANE",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-06",
"last_updated": "2020-07-27",
"certification_date": "2020-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IL",
"license": "135.001086",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "chicago",
"affiliation": "N",
"address_1": "4646 N Marine Dr",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606405759",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Chicago, IL
- Georgia Marinis Diakakis, RD
- Kanella Diakoumis, ATC
- Mariam Diallo Fofana, FNP-BC
- Mamadou Kindy Cherif Diallo, MD
- Reneau Alberta Diallo, CNM APN
- Love Chara Dialogos, LMFT
- Dialogue to Wellness
- Dialysis at Home
- Dialysis Care Center Beverly LLC
- Dialysis Centers of America - Illinois, Inc. (RCG Northwestern)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.