Organization Active NPI

Susan Haido, MD PC

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1851665178
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUSAN HAIDO, MD PC
Practice address
5140 N. California Ave.
Suite #620
Chicago, IL 60625
Phone
(773) 275-8200
Fax
(773) 275-8555
NPI assigned
Mar 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2012

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

Authorized official

Name
Susan Haido, M.D.
Title
Physician
Phone
(773) 275-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X IL Primary

Addresses

Primary practice location

5140 N. California Ave.
Suite #620
Chicago, IL 60625

Mailing address

5140 N. California Ave.
Suite #620
Chicago, IL 60625
Phone (773) 275-8200

Other identifiers 1

IdentifierTypeStateIssuer
036089980MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330905600000",
    "number": "1851665178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 N. CALIFORNIA AVE.",
            "address_2": "SUITE #620",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60625",
            "telephone_number": "773-275-8200",
            "fax_number": "773-275-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 N. CALIFORNIA AVE.",
            "address_2": "SUITE #620",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60625",
            "telephone_number": "773-275-8200",
            "fax_number": "773-275-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN HAIDO, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A",
        "authorized_official_last_name": "HAIDO",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "773-275-8200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089980",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.