DR. SUSAN M FEDINEC (DO) – Family Medicine Physician, NPI 1770549958

DR. SUSAN M FEDINEC (DO) is a healthcare provider. based in Lisle, Illinois. specializing in Family Medicine Physician. They hold the professional credentials DO. They hold a License No. 036098573 (IL). The NPI Number for DR. SUSAN M FEDINEC (DO) is 1770549958

Main info

Female
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. SUSAN M FEDINEC (DO)
NPI
1770549958
Phone
(312) 337-4150
Address
4979 INDIANA AVE STE 312
Enumeration Date
25 April 2006
Last Update Date
20 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3123374150
Graduation Year
1995 (31 years ago)
PAC ID
1052213717
Group Practice PAC ID
3971764762
Professional Enrollment ID
I20040126000021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for DR. SUSAN M FEDINEC (DO)

  • 4979 INDIANA AVE STE 312

    LISLE, IL 605323847

    Phone: (312) 337-4150

    Fax: (312) 337-4311

    Type: Mailing

  • 4979 Indiana Ave Ste 312

    Lisle, IL 60532

    Phone: (312) 337-4150

    Fax: (312) 337-4311

    Type: Location

  • 1 CALIFORNIA ST STE 2300

    SAN FRANCISCO, CA 941115424

    Phone: (800) 997-6196

    Fax: (415) 504-1367

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-01-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040126000021IFamily PracticeILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60532)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971764762View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Physical Therapist In Private PracticeIL
C H I R O P R A C T I CIL
Family PracticeIL
C H I R O P R A C T I CIL
Clinical PsychologistIN
Nurse PractitionerMN
Nurse PractitionerIL

Reviews

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Frequently asked questions

Is DR. SUSAN M FEDINEC (DO) listed with a National Provider Identifier?
Yes — DR. SUSAN M FEDINEC (DO) has NPI 1770549958 on file in the registry.
Active or inactive — what applies to DR. SUSAN M FEDINEC (DO)?
You should see DR. SUSAN M FEDINEC (DO) as active in CMS-hosted NPPES data.
What clinical focus is listed for DR. SUSAN M FEDINEC (DO)?
At a glance, DR. SUSAN M FEDINEC (DO) is tied to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. SUSAN M FEDINEC (DO) associated with Lisle?
Public fields place DR. SUSAN M FEDINEC (DO) around Lisle, Illinois. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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