Active NPI
Vanessa Thiel
- Pediatric Nephrology Physician
- Chicago, IL
National Provider Identifier
1902486814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nephrology Physician
- License
- 036.169336
- Practice address
- 225 E Chicago Ave
Chicago, IL 60611-2991 - Phone
- (312) 227-5705
- NPI assigned
- Apr 13, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Nephrology Physician | 2080P0210X | 036.169336 | IL | Primary |
Addresses
Primary practice location
225 E Chicago Ave
Chicago, IL 60611-2991
Mailing address
225 E Chicago Ave
Chicago, IL 60611-2991
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210702001777 | OH | Order and Referring Only - Pediatric Medicine | 2163823733 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.169336 | IL | MD | Pediatric Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721692800000",
"number": "1902486814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "312-227-5705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIEL",
"first_name": "VANESSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-13",
"last_updated": "2024-07-23",
"certification_date": "2024-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0210X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Nephrology",
"state": "IL",
"license": "036.169336",
"primary": true
}
],
"identifiers": [],
"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 Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.