Individual provider Active NPI

Tamara Rendulic, M.D.

  • Anesthesiology Physician
  • Melrose Park, IL
National Provider Identifier
1114929981
Registry record updated Mar 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036107359 Issued in IL
Practice address
1225 W Lake St
Westlake Hospital / Anesthesia Department
Melrose Park, IL 60160-4039
Phone
(708) 681-3000
NPI assigned
Aug 11, 2005
Last updated
Mar 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2015

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 036107359 IL Primary

Addresses

Primary practice location

1225 W Lake St
Westlake Hospital / Anesthesia Department
Melrose Park, IL 60160-4039

Mailing address

3998 Fair Ridge Drive
Suite 300
Fairfax, VA 22033-2921
Phone (703) 295-9360

Other identifiers 1

IdentifierTypeStateIssuer
036107359MedicaidIL

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
I20041123000424 IL Practitioner - Anesthesiology 4587629175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia Illinois LLCGroup PAC ID 1052576519, 431 clinicians
Anesthesia Associates, LTDGroup PAC ID 2961303425, 34 clinicians

Practice addresses (Care Compare)

1225 W Lake St
Melrose Park, IL 60160-4039
Phone (708) 681-3000

3811 Highland Ave
Downers Grove, IL 60515-1555
Phone (630) 852-9300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia (Illinois), LLC Anesthesiology CurrentSince Jul 11, 2012 Accepting new patients
Anesthesia Associates, LTD CurrentSince Mar 13, 2024 Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

3811 Highland Ave
Downers Grove, IL 60515
Phone (630) 852-9300

1225 W Lake St
Melrose Park, IL 60160
Phone (708) 681-3000

100 5th St
Oswego, IL 60543
Phone (630) 449-0085

2515 Klein Rd
Sycamore, IL 60178
Phone (800) 243-2587

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1114929981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DRIVE",
            "address_2": "SUITE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332921",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W LAKE ST",
            "address_2": "WESTLAKE HOSPITAL / ANESTHESIA DEPARTMENT",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601604039",
            "telephone_number": "708-681-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENDULIC",
        "first_name": "TAMARA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036107359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036107359",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

Verify at the official NPI Registry.