Individual provider Active NPI

Marijana Ljubanovic Lazarevic

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1033135686
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036-093273 Issued in IL
Practice address
1653 W Congress Pkwy
735 Jelke Anesthesia Department
Chicago, IL 60612-3833
Phone
(312) 942-6504
Fax
(312) 942-5773
NPI assigned
Jul 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036-093273 IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy
735 Jelke Anesthesia Department
Chicago, IL 60612-3833

Mailing address

1653 W Congress Pkwy
735 Jelke Anesthesia Department
Chicago, IL 60612-3833
Phone (312) 942-6504

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
I20101208001193 IL Practitioner - Anesthesiology 5395932917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesiologists SCGroup PAC ID 4183512080, 152 clinicians

Practice addresses (Care Compare)

520 S Maple Ave
Oak Park, IL 60304-1022
Phone (312) 563-3971

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-093273ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesiologists SC Anesthesiology CurrentSince Sep 13, 2002 Accepting new patients
Rush University Medical Center Past Accepting new patients

Locations

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1653 W Congress Pkwy
#739
Chicago, IL 60612
Phone (312) 942-3138

1725 W Harrison St
Ste 556
Chicago, IL 60612
Phone (312) 563-2880

1653 W Congress Pkwy
#735
Chicago, IL 60612
Phone (312) 942-6504

2011 York Rd
Ste 3000
Oak Brook, IL 60523
Phone (414) 732-2577

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1033135686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "address_2": "735 JELKE ANESTHESIA DEPARTMENT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-6504",
            "fax_number": "312-942-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "address_2": "735 JELKE ANESTHESIA DEPARTMENT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-6504",
            "fax_number": "312-942-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LJUBANOVIC LAZAREVIC",
        "first_name": "MARIJANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036-093273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.