Individual provider Active NPI

Bernard Wittels, M.D., PH.D.

  • Anesthesiology Physician
  • Evanston, IL
National Provider Identifier
1073618427
Registry record updated Jul 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036079949 Issued in IL
Practice address
355 Ridge Ave
Evanston, IL 60202-3328
Phone
(847) 316-6370
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036079949 IL Primary
Anesthesiology Physician 207L00000X 2011030637 MO

Addresses

Primary practice location

355 Ridge Ave
Evanston, IL 60202-3328

Mailing address

1301 W 22ND St
Suite 610
Oak Brook, IL 60523-2006
Phone (630) 537-1720

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
I20050609000921 IL Practitioner - AnesthesiologyPractitioner - Interventional Pain ManagementPractitioner - Pain Management 2668415605 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
036079949ILMDAnesthesiology Physician
2011030637MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Illinois, LLC Anesthesiology CurrentSince Jun 1, 2016 Accepting new patients
Town Square Anesthesia LLC Anesthesiology CurrentSince Feb 1, 2022 Accepting new patients
Huntley Anesthesia Associates LLC Anesthesiology CurrentSince Mar 1, 2022 Accepting new patients
Racine Anesthesia Services, LLC Anesthesiology Past Accepting new patients
Laboratory Corportation of America Holdings Past Accepting new patients
University Anesthesiologists SC Anesthesiology Past Accepting new patients

Locations

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977

10350 Haligus Rd
Huntley, IL 60142
Phone (847) 802-7150

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

3703 Doty Rd
Woodstock, IL 60098
Phone (815) 334-3170

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373760000000",
    "number": "1073618427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W 22ND ST",
            "address_2": "SUITE 610",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232006",
            "telephone_number": "630-537-1720",
            "fax_number": "630-537-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023328",
            "telephone_number": "847-316-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTELS",
        "first_name": "BERNARD",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2013-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036079949",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2011030637",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.