Individual provider Active NPI

Karin B Ulstrup, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1922091420
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036110743 Issued in IL
Practice address
259 E Erie St
Ste 2330
Chicago, IL 60611-2987
Phone
(312) 926-6000
Fax
(312) 926-6323
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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 036110743 IL Primary

Addresses

Primary practice location

259 E Erie St
Ste 2330
Chicago, IL 60611-2987

Mailing address

259 E Erie St
Ste 2330
Chicago, IL 60611-2987
Phone (312) 926-6000

Other practice location 1

1276 N Clybourn Ave
Chicago, IL 60610-2089
Phone (312) 337-1073

Other identifiers 1

IdentifierTypeStateIssuer
036110743MedicaidIL

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
I20040823001266 IL Practitioner - Internal Medicine 1153395488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Near North Health Service CorporationGroup PAC ID 9638165749, shared by 8 NPIs, 26 clinicians
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

1276 N Clybourn Ave
Chicago, IL 60610-2089
Phone (312) 337-1073

1630 Sherman Ave
Evanston, IL 60201-3711

4445 W Irving Park Rd
Chicago, IL 60641-2808

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

800 N W Moreland Rd
Suite 102
Lake Forest, IL 60045-1687
Phone (847) 582-2104

800 N Westmoreland Rd
Suite 201
Lake Forest, IL 60045-1687
Phone (847) 535-7647

870 N Milwaukee Ave
Vernon Hills, IL 60061-1521

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2013 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2013 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

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

259 E Erie St
Ste 2330
Chicago, IL 60611
Phone (312) 926-6600

676 N Saint Clair St
Ste 370
Chicago, IL 60611
Phone (312) 787-6662

680 N Lake Shore Dr
Ste 1015
Chicago, IL 60611
Phone (312) 926-9674

676 N Saint Clair St
Ste 300
Chicago, IL 60611
Phone (312) 787-2773

Organizations & group practices 2

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1922091420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST",
            "address_2": "STE 2330",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-926-6000",
            "fax_number": "312-926-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST",
            "address_2": "STE 2330",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-926-6000",
            "fax_number": "312-926-6323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1276 N Clybourn Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606102089",
            "country_code": "US",
            "telephone_number": "312-337-1073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ULSTRUP",
        "first_name": "KARIN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036110743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036110743",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.