Individual provider Active NPI

Clare Kelly Reidy, DO

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1952098568
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125.081298 Issued in IL
Practice address
7435 W Talcott Ave
Chicago, IL 60631-3707
Phone
(773) 792-5155
Fax
(773) 594-7975
NPI assigned
Apr 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 125.081298 IL Primary

Addresses

Primary practice location

7435 W Talcott Ave
Chicago, IL 60631-3707

Mailing address

7435 W Talcott Ave
Chicago, IL 60631-3746
Phone (773) 790-5255

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2336 N Lister Ave
Apt 3
Chicago, IL 60614-0846

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.081298ILMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1952098568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313746",
            "telephone_number": "773-790-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313707",
            "telephone_number": "773-792-5155",
            "fax_number": "773-594-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIDY",
        "first_name": "CLARE",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.081298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.