Individual provider Active NPI

Daniel M Derman, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1912947458
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-072292 Issued in IL
Practice address
201 E Huron St
12TH Floor, Suite 105
Chicago, IL 60611-3197
Phone
(312) 926-3642
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-072292 IL Primary

Addresses

Primary practice location

201 E Huron St
12TH Floor, Suite 105
Chicago, IL 60611-3197

Mailing address

201 E Huron St
12TH Floor, Suite 105
Chicago, IL 60611-3197

Other identifiers 1

IdentifierTypeStateIssuer
036-072292MedicaidIL

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
I20100817001408 IL Practitioner - Internal Medicine 7810894672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

1333 W Belmont Ave
Chicago, IL 60657-5785

1630 Sherman Ave
Evanston, IL 60201-3711

350 S Waukegan
Suite 150
Deerfield, IL 60015-5239
Phone (312) 926-3107

350 S Waukegan Rd
Deerfield, IL 60015-5239
Phone (312) 926-6146

4445 W Irving Park Rd
Chicago, IL 60641-2808

4732 N Lincoln Ave
Chicago, IL 60625-8561
Phone (847) 475-2273

633 N Saint Clair St
Chicago, IL 60611-3234

635 N Dearborn St
Chicago, IL 60654-4618
Phone (312) 926-0404

636 Raymond Dr
Suite 107
Naperville, IL 60563-9789
Phone (630) 416-2300

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

885 Roosevelt Rd
Glen Ellyn, IL 60137-6141

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Shirley Ryan Abilitylab Inpatient rehabilitation facility, Chicago, IL, CCN 143026

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-072292ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2014 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Central Dupage Physician Group Internal Medicine Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

259 E Erie St
Ste 2150
Chicago, IL 60611
Phone (312) 926-5111

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

111 W Washington St
Ste 1801
Chicago, IL 60602
Phone (312) 726-8800

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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 5

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1912947458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E HURON ST",
            "address_2": "12TH FLOOR, SUITE 105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E HURON ST",
            "address_2": "12TH FLOOR, SUITE 105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113197",
            "telephone_number": "312-926-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERMAN",
        "first_name": "DANIEL",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-072292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-072292",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.