Active NPI
Ronny Chan, MD
- Anesthesiology Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 125.071920
- Practice address
- 5841 S Maryland Ave # Mc4028
Chicago, IL 60637-1443 - Phone
- (773) 702-6842
- Fax
- (773) 834-0063
- NPI assigned
- Jun 12, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 125.071920 | IL | Primary |
Addresses
Primary practice location
5841 S Maryland Ave # Mc4028
Chicago, IL 60637-1443
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, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221121001189 | IL | Practitioner - Anesthesiology | 9436406097 | Reassigns benefits to 1 organization |
| I20241024003526 | WA | Practitioner - Anesthesiology | 9436406097 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7320 216TH St SW
Suite 140
Edmonds, WA 98026-8028
Phone (425) 673-3760
Hospital & facility affiliations
- Swedish Edmonds Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The University of Chicago Medical Center | Current | Accepting new patients | |
| Pacific Anesthesia PC | Anesthesiology | Current | Accepting new patients |
| The University of Chicago Medical Center | Current | Accepting new patients | |
| University of Chicago Medical Center | Past | Accepting new patients |
Locations
150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061
16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970
7320 216th St SW
Ste 140
Edmonds, WA 98026
Phone (425) 673-3750
1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101
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.
-
- Community/Retail Pharmacy
- Calumet City, IL
- NPI 1255895678
-
- Chronic Disease Hospital
- Chicago, IL
- NPI 1831401520
Hospital & facility affiliations 2
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": "1528761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528761600000",
"number": "1134612484",
"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 # MC4028",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371443",
"telephone_number": "773-702-6842",
"fax_number": "773-834-0063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "RONNY",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-12",
"last_updated": "2018-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "125.071920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.