Mrs Susanna Antonia Mccolley, MD is a medicare enrolled "Pediatrics - Pediatric Pulmonology" physician in Chgo, Illinois. Her current practice location is
2300 Childrens Plaza, #43, Chgo, Illinois. You can reach out to her office (for appointments etc.) via phone at
(773) 880-8104.
Mrs Susanna Antonia Mccolley is licensed to practice in Illinois (license number 36089384) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1962470336.
Physician's Profile
Full Name | Mrs Susanna Antonia Mccolley |
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Gender | Female |
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Speciality | Pediatrics - Pediatric Pulmonology |
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Location | 2300 Childrens Plaza, Chgo, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1962470336
- Provider Enumeration Date: 03/10/2006
- Last Update Date: 09/21/2011
Medicare PECOS Information:
- PECOS PAC ID: 0547255903
- Enrollment ID: I20040416000324
Medical Identifiers
Medical identifiers for Mrs Susanna Antonia Mccolley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1962470336 | NPI | - | NPPES |
036089384 | Medicaid | IL | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2080P0214X | Pediatrics - Pediatric Pulmonology | 36089384 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Susanna Antonia Mccolley allows following entities to bill medicare on her behalf.
Entity Name | Pediatric Faculty Foundation Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1518064716 PECOS PAC ID: 4789597279 Enrollment ID: O20031111000157 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Susanna Antonia Mccolley is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Susanna Antonia Mccolley, MD 1137 West Montana, Chgo, IL 60614-2220 Ph: (773) 348-0979 | Mrs Susanna Antonia Mccolley, MD 2300 Childrens Plaza, #43, Chgo, IL 60614 Ph: (773) 880-8104 |
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