Mary E McRaven, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085004482 Issued in IL

Practice address

911 N Elm St
Suite 128
Hinsdale, IL 60521-3634

Phone

(630) 856-7460

Fax

(630) 655-9943

NPI assigned

Oct 9, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary E Polniak Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Loyola University Medical Center

  • General Practice Physician
  • Maywood, IL
  • NPI 1336159961
  Medicare reassignment NPD
• Vascular and Interventional Professionals, LLC

  • Vascular & Interventional Radiology Physician
  • Hinsdale, IL
  • NPI 1750767745
  Medicare reassignment
• Loyola University Medical Center

  dba Mulcahy Pharmacy

  • Community/Retail Pharmacy
  • Maywood, IL
  • NPI 1184789299
  NPD
• Adventist Health Partners, Inc

  dba Hinsdale Internal Medicine

  • Internal Medicine Physician
  • Westmont, IL
  • NPI 1306889654
  NPD (past)
• Adventist Health Partners,Inc

  dba Glendale Family Practice

  • Family Medicine Physician
  • Bloomingdale, IL
  • NPI 1043255888
  NPD (past)
• Vein Clinics of Chicago LLC

  • Vascular Surgery Physician
  • Chicago, IL
  • NPI 1386904621
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1003168428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD",
            "address_2": "STE 300",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151069",
            "telephone_number": "630-856-7460",
            "fax_number": "630-655-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N ELM ST",
            "address_2": "SUITE 128",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213634",
            "telephone_number": "630-856-7460",
            "fax_number": "630-655-9943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCRAVEN",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmcraven135050@direct.luhs.org",
            "affiliation": "Y",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "POLNIAK",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Robert McMahon, M.D.
• Maureen M McNamee, CNM
• Laura N. McPartlin, PHD
• Dana McPherrin
• Pamela Joan McQuaid, LCSW
• Kaitlin McWatters
• MD Medical Group, S.C.
• Meccia Mental Health LLC
• Salvatore Meccia, MD
• Medical Neurology Associates SC

• Physician Assistant in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.