Active NPI
Rachel W Vidal, MD
- Emergency Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036161404
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208974 | Medicaid | SC |
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
Enrollment records 1
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
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
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.19 of 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 20897 | SC | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | 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.
-
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
-
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1497859649
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.