Individual provider Active NPI

Joseph Cyriac, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1104846963
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036115037 Issued in IL
Practice address
3435 W Van Buren St
Chicago, IL 60624-3312
Phone
(773) 265-3583
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036115037 IL Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 036115037 IL
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 036115037 IL

Addresses

Primary practice location

3435 W Van Buren St
Chicago, IL 60624-3312

Mailing address

PO Box 93554
Chicago, IL 60673-3554
Phone (630) 734-0200

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
I20060508000775 IL Practitioner - Family PracticePractitioner - Pediatric Medicine 7618988403 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medical Specialists II SCGroup PAC ID 6002711603, 8 clinicians

Practice addresses (Care Compare)

3435 W Van Buren St
Chicago, IL 60624-3312
Phone (773) 826-6300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036115037ILMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Specialists, II, S.C. CurrentSince Feb 23, 2014 Accepting new patients
Endeavor Health Medical Group Family Medicine CurrentSince Mar 28, 2019 Accepting new patients
Endeavor Health Medical Group CurrentSince Mar 28, 2019 Accepting new patients
Extended Care Specialist, LTD Family Medicine Past Accepting new patients
Advocate Health & Hospitals Corp. Past Accepting new patients

Locations

3435 W Van Buren St
Chicago, IL 60624
Phone (773) 265-7700

9532 Eagle Way
Chicago, IL 60678

34816 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Organizations & group practices 5

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1104846963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93554",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606733554",
            "telephone_number": "630-734-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 W VAN BUREN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606243312",
            "telephone_number": "773-265-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYRIAC",
        "first_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036115037",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036115037",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "IL",
            "license": "036115037",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.