Individual provider Active NPI

Bobiejo A Ferguson Bryan, MD

  • Surgery Physician
  • Chicago, IL
National Provider Identifier
1003300682
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
125.072453 Issued in IL
Practice address
5841 S Maryland Ave # Mc6040
Chicago, IL 60637-1443
Phone
(773) 702-1000
Fax
(773) 702-2140
NPI assigned
Jun 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 036180263 IL
Surgery Physician 208600000X 125.072453 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave # Mc6040
Chicago, IL 60637-1443

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-4503
Phone (773) 702-1150

Other practice location 1

250 E Superior St Ste 4-420
Chicago, IL 60611-2914
Phone (312) 695-0990

Other names 1

  • Bobiejo Ferguson Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180723000330 IL Order and Referring Only - General SurgeryPractitioner - General Surgery 9830446814

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

250 E Superior St
Suite 4 420
Chicago, IL 60611-2914

5777 Dept
Carol Stream, IL 60122-0021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125.072453ILMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1003300682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605274503",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC6040",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-702-1000",
            "fax_number": "773-702-2140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 E Superior St Ste 4-420",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112914",
            "country_code": "US",
            "telephone_number": "312-695-0990",
            "fax_number": "312-472-4781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERGUSON BRYAN",
        "first_name": "BOBIEJO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "IL",
            "license": "036180263",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125.072453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOBIEJO",
            "last_name": "FERGUSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.