Individual provider Active NPI

David G Ruschhaupt, MD

  • Pediatric Cardiology Physician
  • Chicago, IL
National Provider Identifier
1932259975
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
036057563 Issued in IL
Practice address
1653 W Congress Pkwy
770 Jones
Chicago, IL 60612-3833
Phone
(312) 942-7496
Fax
(312) 942-6800
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 036057563 IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy
770 Jones
Chicago, IL 60612-3833

Mailing address

1653 W Congress Pkwy
770 Jones
Chicago, IL 60612-3833
Phone (312) 942-7496

Other identifiers 1

IdentifierTypeStateIssuer
036057563MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1932259975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "address_2": "770 JONES",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-7496",
            "fax_number": "312-942-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "address_2": "770 JONES",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-7496",
            "fax_number": "312-942-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSCHHAUPT",
        "first_name": "DAVID",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "IL",
            "license": "036057563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036057563",
            "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 Sep 22, 2011; 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.