Individual provider Active NPI

Marina Bekic, D.O.

  • Emergency Medicine Physician
  • Chicago Heights, IL
National Provider Identifier
1104863919
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-095729 Issued in IL
Practice address
1423 Chicago Rd
Chicago Heights, IL 60411
Phone
(708) 756-1000
NPI assigned
Jun 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-095729 IL Primary

Addresses

Primary practice location

1423 Chicago Rd
Chicago Heights, IL 60411

Mailing address

555 W Court St
Kankakee, IL 60901-3675
Phone (888) 828-3192

Other practice location 1

403 E 1st St
Dixon, IL 61021-3116
Phone (815) 285-5552

Other identifiers 3

IdentifierTypeStateIssuer
F400405641OtherILMEDICARE PTAN
036095729MedicaidIL
F400405641OtherILMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-095729ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate North Side Health Network Past Accepting new patients
Emergency Room Care Providers, S.C. Emergency Medicine PastSince Jul 25, 2019 Accepting new patients
Webster Emergency Physicians Emergency Medicine Past Accepting new patients
Emergency Medical Care West Emergency Medicine Past Accepting new patients
Presence Healthcare Services Past Accepting new patients

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1104863919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W COURT ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013675",
            "telephone_number": "888-828-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 CHICAGO RD",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "60411",
            "telephone_number": "708-756-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 E 1st St",
            "address_purpose": "LOCATION",
            "city": "Dixon",
            "state": "IL",
            "postal_code": "610213116",
            "country_code": "US",
            "telephone_number": "815-285-5552",
            "fax_number": "815-285-5865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEKIC",
        "first_name": "MARINA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-095729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F400405641",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095729",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "F400405641",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.