Individual provider Active NPI

Susan Fox, PA-C, MMS

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1992919401
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085002353 Issued in IL
Practice address
1725 W Harrison St Ste 117
Chicago, IL 60612-3848
Phone
(312) 942-6296
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085002353 IL Primary

Addresses

Primary practice location

1725 W Harrison St Ste 117
Chicago, IL 60612-3848

Mailing address

1656 W Farwell Ave Apt 3F
Chicago, IL 60626-3623

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090617000048 IL Practitioner - Physician Assistant 4880624428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1625 N Harlem Ave
Chicago, IL 60707-4303

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

1725 W Harrison St
Chicago, IL 60612-3848

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085002353ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center CurrentSince Jun 12, 2020 Accepting new patients
Rush University Medical Group CurrentSince Jun 12, 2020 Accepting new patients

Locations

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1725 W Harrison St
Ste 117
Chicago, IL 60612
Phone (312) 942-6292

1625 N Harlem Ave
Chicago, IL 60707
Phone (312) 256-8583

75 Remittance Dr
Dept 1611
Chicago, IL 60675

2011 York Rd
Ste 2000A
Oak Brook, IL 60523
Phone (312) 947-7546

Interoperability endpoints

  • Direct secure messaging: sfox3176@direct.rush.rush-health.com

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 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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992919401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1656 W FARWELL AVE APT 3F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606263623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 117",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123848",
            "telephone_number": "312-942-6296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C, MMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.