NPIMap

Individual provider Active NPI

Diana A. Guse, M.D.

  • Pediatrics Physician
  • Mundelein, IL
National Provider Identifier
1912134313
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036135358 Issued in IL
Practice address
1162 W Maple Ave
Mundelein, IL 60060
Phone
(847) 367-2400
Fax
(847) 367-2440
NPI assigned
Jun 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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 036135358 IL
Pediatrics Physician 208000000X 036135358 IL Primary

Addresses

Primary practice location

1162 W Maple Ave
Mundelein, IL 60060

Mailing address

1162 W Maple Ave
Mundelein, IL 60060-1438
Phone (847) 367-2400

Other practice location 1

660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dguse259373@direct.northshore.org

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
I20140605001034 IL Practitioner - General PracticePractitioner - Internal Medicine 5890933774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Internal Medicine
Education
Rush Medical College of Rush University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1162 W Maple Ave
Mundelein, IL 60060-1438
Phone (847) 367-2400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 7, 2014 Accepting new patients
Endeavor Health Medical Group CurrentSince Jan 31, 2016 Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Jan 31, 2016 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 7, 2014 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

660 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6100

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1162 W Maple Ave
Mundelein, IL 60060
Phone (847) 367-2400

Interoperability endpoints

  • Direct secure messaging: dguse259373@direct.northshore.org

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 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": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1912134313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1162 W MAPLE AVE",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601438",
            "telephone_number": "847-367-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1162 W MAPLE AVE",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "60060",
            "telephone_number": "847-367-2400",
            "fax_number": "847-367-2440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 N Westmoreland Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "IL",
            "postal_code": "600451659",
            "country_code": "US",
            "telephone_number": "847-234-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUSE",
        "first_name": "DIANA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036135358",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036135358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dguse259373@direct.northshore.org",
            "affiliation": "N",
            "address_1": "1162 W Maple Ave",
            "city": "Mundelein",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mundelein, IL

Sources for this page

Verify at the official NPI Registry.