Individual provider Active NPI

Rachel W Vidal, MD

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1962463281
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036161404 Issued in IL
Practice address
211 E Ontario St Ste 200
Chicago, IL 60611-3284
Phone
(312) 694-7000
Fax
(312) 926-6274
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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 20897 SC
Emergency Medicine Physician 207P00000X 036161404 IL Primary

Addresses

Primary practice location

211 E Ontario St Ste 200
Chicago, IL 60611-3284

Mailing address

211 E Ontario St Ste 200
Chicago, IL 60611-3284
Phone (312) 694-7000

Other practice location 1

14 Richland Medical Park Dr
Suite 320
Columbia, SC 29203-6877
Phone (803) 434-6771

Other practice location 2

129 N Washington St
Sumter, SC 29150-4949
Phone (803) 774-9680

Other identifiers 1

IdentifierTypeStateIssuer
208974MedicaidSC

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
I20220901001422 IL Practitioner - Emergency Medicine 1759453434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Michigan Medical School, 1995
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)

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

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
20897SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2022 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

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

211 E Ontario St
Ste 200
Chicago, IL 60611
Phone (312) 694-7000

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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 1

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1962463281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E ONTARIO ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113284",
            "telephone_number": "312-694-7000",
            "fax_number": "312-926-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E ONTARIO ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113284",
            "telephone_number": "312-694-7000",
            "fax_number": "312-926-6274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Richland Medical Park Dr",
            "address_2": "Suite 320",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036877",
            "country_code": "US",
            "telephone_number": "803-434-6771",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "129 N Washington St",
            "address_purpose": "LOCATION",
            "city": "Sumter",
            "state": "SC",
            "postal_code": "291504949",
            "country_code": "US",
            "telephone_number": "803-774-9680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIDAL",
        "first_name": "RACHEL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "20897",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036161404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208974",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.