Individual provider Active NPI

Susan Debra Elbaum, MD

  • Internal Medicine Physician
  • Arlington Heights, IL
National Provider Identifier
1972643633
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-104303 Issued in IL
Practice address
1051 W Rand Rd # 110
Arlington Heights, IL 60004-2315
Phone
(847) 618-9292
Fax
(847) 618-9294
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 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 036-104303 IL Primary

Addresses

Primary practice location

1051 W Rand Rd # 110
Arlington Heights, IL 60004-2315

Mailing address

1051 W Rand Rd Ste 110
Arlington Heights, IL 60004-2315
Phone (847) 618-9292

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address selbaum23528@direct.nch.org

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
I20101108001360 IL Practitioner - Internal Medicine 8325080807 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rush Medical College of Rush University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1051 W Rand Rd
Arlington Heights, IL 60004-2315

1200 W Algonquin Rd
Palatine, IL 60067-7373
Phone (847) 618-0535

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

  • Residential Home Health Home health agency, Schaumburg, IL, CCN 147094
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-104303ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Nov 20, 2023 Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Nov 20, 2023 Accepting new patients
Northwest Community Health Services Inc CurrentSince Oct 5, 2010 Accepting new patients
Northwest Community Health Services Inc Internal Medicine CurrentSince Oct 5, 2010 Accepting new patients

Locations

1051 W Rand Rd
Ste 110
Arlington Heights, IL 60004
Phone (847) 618-9292

1051 W Rand Rd
Arlington Hts, IL 60004
Phone (847) 221-4601

1450 Busch Pkwy
Buffalo Grove, IL 60089
Phone (847) 459-7860

25233 Network Pl
Chicago, IL 60673

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

Organizations & group practices 4

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 3

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1972643633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 W RAND RD STE 110",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600042315",
            "telephone_number": "847-618-9292",
            "fax_number": "848-618-9294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 W RAND RD # 110",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600042315",
            "telephone_number": "847-618-9292",
            "fax_number": "847-618-9294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELBAUM",
        "first_name": "SUSAN",
        "middle_name": "DEBRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-104303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "selbaum23528@direct.nch.org",
            "affiliation": "N",
            "address_1": "1051 W Rand Rd # 110",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600042315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.