Individual provider Active NPI

Theresa J Lie-Nemeth, MD

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
National Provider Identifier
1841280922
Registry record updated Jul 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
036109913 Issued in IL
Practice address
1401 S. California Blvd.
Chicago, IL 60608
Phone
(773) 522-5857
Fax
(773) 522-5886
NPI assigned
Oct 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 220616 MA
Physical Medicine & Rehabilitation Physician 208100000X 036109913 IL Primary

Addresses

Primary practice location

1401 S. California Blvd.
Chicago, IL 60608

Mailing address

1401 S. California Blvd.
Chicago, IL 60608
Phone (773) 522-5857

Other identifiers 3

IdentifierTypeStateIssuer
469219OtherMATUFTS HEALTH PLAN
2077671MedicaidMA
J27613OtherMABCBS MA

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
I20061003000054 IL Practitioner - Physical Medicine and RehabilitationPractitioner - Orthopedic Surgery 7810960101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Medical College of Ohio, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schwab Faculty Associates IncGroup PAC ID 0244203032, 10 clinicians

Practice addresses (Care Compare)

1401 S California Ave
Chicago, IL 60608-1858
Phone (773) 522-2010

Hospital & facility affiliations

  • Schwab Rehabilitation Hospital Inpatient rehabilitation facility, Chicago, IL, CCN 143025

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036109913ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Schwab Faculty Associates Inc Physical Medicine & Rehabilitation CurrentSince Jul 17, 2006 Accepting new patients
Schwab Rehabilitation Hospital and Care Network Past Accepting new patients
Avant-Garde Medicne SC Physical Medicine & Rehabilitation Past Accepting new patients
Mount Sinai Hospital Medical Center of Chicago Past Accepting new patients

Locations

28687 Network Pl
Chicago, IL 60673

1401 S California Ave
Chicago, IL 60608
Phone (773) 522-5853

Interoperability endpoints

  • Direct secure messaging: tlienemeth70319@uihealth.direct-ci.com

Organizations & group practices 4

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280448000000",
    "number": "1841280922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S. CALIFORNIA BLVD.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60608",
            "telephone_number": "773-522-5857",
            "fax_number": "773-522-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S. CALIFORNIA BLVD.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60608",
            "telephone_number": "773-522-5857",
            "fax_number": "773-522-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIE-NEMETH",
        "first_name": "THERESA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2010-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "220616",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036109913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "469219",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2077671",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J27613",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.