Active NPI
Bobiejo A Ferguson Bryan, MD
- Surgery Physician
- Chicago, IL
National Provider Identifier
1003300682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 125.072453
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180723000330 | IL | Order and Referring Only - 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
| License | State | Type | Specialty |
|---|---|---|---|
| 125.072453 | IL | MD | Surgery 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.