Active NPI
Oleh R Terleckyj, MD
- Internal Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0360795Z1
- Practice address
- 2740 W Foster Ave
Ste LL7
Chicago, IL 60625 - Phone
- (773) 878-8200
- Fax
- (773) 293-4197
- NPI assigned
- Jul 16, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0360795Z1 | IL | Primary |
Addresses
Primary practice location
2740 W Foster Ave
Ste LL7
Chicago, IL 60625
Mailing address
2740 W Foster Ave
Ste LL7
Chicago, IL 60625
Phone (773) 878-8200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0360795Z1 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | oterleckyj277031@direct.northshore.org |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0360795Z1 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Current | Accepting new patients | |
| Endeavor Health Medical Group | Internal Medicine | Current | Accepting new patients |
Locations
2740 W Foster Ave
Ste LL7
Chicago, IL 60625
5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140
5140 N California Ave
#405
Chicago, IL 60625
Phone (773) 275-5558
5140 N California Ave
Ste 405
Chicago, IL 60625
Phone (773) 275-5558
9532 Eagle Way
Chicago, IL 60678
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Evanston, IL
- NPI 1497701882
Internal Medicine
-
- Obstetrics & Gynecology Physician
- Chicago, IL
- NPI 1760432348
-
- Anesthesiology Physician
- Evanston, IL
- NPI 1265695944
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604016000000",
"number": "1144247958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2740 W FOSTER AVE",
"address_2": "STE LL7",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60625",
"telephone_number": "773-878-8200",
"fax_number": "773-293-4197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2740 W FOSTER AVE",
"address_2": "STE LL7",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60625",
"telephone_number": "773-878-8200",
"fax_number": "773-293-4197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERLECKYJ",
"first_name": "OLEH",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-16",
"last_updated": "2020-10-30",
"certification_date": "2020-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "0360795Z1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0360795Z1",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "oterleckyj277031@direct.northshore.org",
"affiliation": "N",
"address_1": "2740 W Foster Ave",
"address_2": "Ste LL7",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "60625",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Oct 30, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.