MEDICARE: MINDY L. SIMPSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	45736	CO
2	2080P0207X	Pediatric Hematology & Oncology Physician	036-114998	IL
3	208000000X	Pediatrics Physician	036-114998	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1992758544	OTHER	IL	CMMG NPI
2	021622158	OTHER	IL	CMMG BLUE SHIELD

General Provider Information

NPI Number	:	1164477246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINDY L. SIMPSON M.D.

Provider Business Mailing Address
First Line	:	1653 W CONGRESS PKWY
Second Line	:	1591 JELKE
City	:	CHICAGO
State	:	IL
Zip	:	60612-3833
Country	:	US
Telephone Number	:	312-942-8114
Fax Number	:	312-942-8975

Provider Business Practice Location Address
First Line	:	1653 W CONGRESS PKWY
Second Line	:	1591 JELKE
City	:	CHICAGO
State	:	IL
Zip	:	60612-3833
Country	:	US
Telephone Number	:	312-942-8114
Fax Number	:	312-942-8975

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	01/13/2026

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Directions to “ MINDY L. SIMPSON M.D.” Practice Location

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