Individual provider Active NPI

Barry P Atlas, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1073513305
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Practice address
6374 N Lincoln Ave
Suite 312
Chicago, IL 60659-1275
Phone
(773) 588-7710
Fax
(773) 561-8977
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X IL Primary

Addresses

Primary practice location

6374 N Lincoln Ave
Suite 312
Chicago, IL 60659-1275

Mailing address

6374 N Lincoln Ave
Suite 312
Chicago, IL 60659-1275
Phone (773) 588-7710

Other identifiers 1

IdentifierTypeStateIssuer
01615754OtherILBLUE CROSS BLUE SHIELD

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
I20191003000665 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7315036258

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-047461ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Physicians LTD. Internal Medicine CurrentSince Nov 30, 2007 Accepting new patients

Locations

6374 N Lincoln Ave
Ste 312
Chicago, IL 60659
Phone (312) 308-0219

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1073513305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6374 N LINCOLN AVE",
            "address_2": "SUITE 312",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591275",
            "telephone_number": "773-588-7710",
            "fax_number": "773-561-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6374 N LINCOLN AVE",
            "address_2": "SUITE 312",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591275",
            "telephone_number": "773-588-7710",
            "fax_number": "773-561-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATLAS",
        "first_name": "BARRY",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01615754",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.