Individual provider Active NPI

Mark Tancredi, M.D.

  • Pulmonary Disease Physician
  • Chicago, IL
National Provider Identifier
1134581317
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036148931 Issued in IL
Practice address
5841 S Maryland Ave Ste Mc6076
Chicago, IL 60637-1626
Phone
(773) 702-9660
Fax
(773) 834-7068
NPI assigned
Mar 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036148931 IL
Pulmonary Disease Physician 207RP1001X 036148931 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave Ste Mc6076
Chicago, IL 60637-1626

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150

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
I20200603001175 IL Practitioner - Pulmonary DiseasePractitioner - HospitalistPractitioner - Internal Medicine 1658665229 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1520 W Harrison St
Chicago, IL 60607-3106
Phone (312) 942-5904

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119
  • Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036148931ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center CurrentSince May 15, 2025 Accepting new patients
Rush University Medical Group Internal Medicine CurrentSince May 15, 2025 Accepting new patients
The University of Chicago Medical Center CurrentSince Jul 1, 2024 Accepting new patients
The University of Chicago Medical Center CurrentSince Jul 1, 2024 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

1520 W Harrison St
Chicago, IL 60607
Phone (312) 226-2371

1520 W Harrison St
Fl 6
Chicago, IL 60607
Phone (312) 942-6744

5841 S Maryland Ave
Ste MC6076
Chicago, IL 60637
Phone (773) 702-1856

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1625 N Harlem Ave
Chicago, IL 60707
Phone (312) 256-8583

75 Remittance Dr
Dept 1611
Chicago, IL 60675

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1134581317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE STE MC6076",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371626",
            "telephone_number": "773-702-9660",
            "fax_number": "773-834-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANCREDI",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-25",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036148931",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036148931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.