NPIMap

Individual provider Active NPI

Amelia M Conte-Russian, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Chicago, IL
National Provider Identifier
1851338792
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
036067744 Issued in IL
Practice address
3319 N Elston Ave
Suite 100
Chicago, IL 60618
Phone
(773) 751-7200
Fax
(773) 583-4295
NPI assigned
May 31, 2006
Last updated
Oct 22, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036067744 IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036067744 IL Primary

Addresses

Primary practice location

3319 N Elston Ave
Suite 100
Chicago, IL 60618

Mailing address

3319 N Elston Ave
Suite 100
Chicago, IL 60618
Phone (773) 751-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050405000038 IL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 7416904271 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Care Home Physicians LLCGroup PAC ID 7517399942, 7 clinicians

Practice addresses (Care Compare)

2250 E Devon Ave
Suite 217
Des Plaines, IL 60018-4526
Phone (847) 238-8300

6044 N Nassau Ave
Chicago, IL 60631-2649
Phone (847) 238-8300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036067744ILMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Care Home Physicians LLC CurrentSince Feb 3, 2023 Accepting new patients
Mobile Ultrasound LLC Past Accepting new patients
Lake Mi Mobile Doctors P.C. Geriatric Medicine Past Accepting new patients
Lake Mi Mobile Doctors, P.C. Past Accepting new patients

Locations

2250 E Devon Ave
Ste 217
Des Plaines, IL 60018
Phone (847) 238-8300

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1851338792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 N ELSTON AVE",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60618",
            "telephone_number": "773-751-7200",
            "fax_number": "773-583-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 N ELSTON AVE",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60618",
            "telephone_number": "773-751-7200",
            "fax_number": "773-583-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONTE-RUSSIAN",
        "first_name": "AMELIA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036067744",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036067744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.