NPIMap

Organization Active NPI

Gottlieb Midwest Anesthesiologists, LLC

  • Anesthesiology Physician
  • Melrose Park, IL
National Provider Identifier
1003832767
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
GOTTLIEB MIDWEST ANESTHESIOLOGISTS, LLC
Practice address
701 West North Avenue
Melrose Park, IL 60160-1612
Phone
(708) 681-3202
NPI assigned
Jul 14, 2006
Last updated
Jun 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Howard S Konowitz, MDNPI 1457379976
Title
Managing Partner
Phone
(847) 921-9733

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

701 West North Avenue
Melrose Park, IL 60160-1612

Mailing address

1121 Lake Cook Road
Suite M
Deerfield, IL 60015-5234
Phone (847) 945-4550

Other identifiers 1

IdentifierTypeStateIssuer
4923596OtherILBCBSIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000619 IL Part B Supplier - Clinic/Group Practice 8123929940 Receives reassigned benefits from 80 practitioners
Practice locations: Park Ridge, IL; Westmont, IL; Plainfield, IL; Orland Park, IL; Melrose Park, IL; La Grange, IL

National Provider Directory

National Provider Directory

Locations

9145 Collection Ctr Dr
Chicago, IL 60693

387 Shuman Blvd
Ste 240W
Naperville, IL 60563

15300 West Ave
Ste 260
Orland Park, IL 60462
Phone (708) 460-5550

Practitioners & affiliated clinicians

Practitioners 106

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 106

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1003832767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 LAKE COOK ROAD",
            "address_2": "SUITE M",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155234",
            "telephone_number": "847-945-4550",
            "fax_number": "847-948-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WEST NORTH AVENUE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601612",
            "telephone_number": "708-681-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOTTLIEB MIDWEST ANESTHESIOLOGISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "KONOWITZ",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "847-921-9733",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "4923596",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.