Individual provider Active NPI

M Barry Kirschenbaum, MD

  • Specialist
  • Chicago, IL
National Provider Identifier
1154379386
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036035278 Issued in IL
Practice address
2740 W Foster Ave
Chicago, IL 60625-3500
Phone
(773) 271-4442
Fax
(708) 590-7148
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036035278 IL Primary

Addresses

Primary practice location

2740 W Foster Ave
Chicago, IL 60625-3500

Mailing address

2740 W Foster Ave
Suite#305
Chicago, IL 60625-3500
Phone (773) 271-4442

Other identifiers 3

IdentifierTypeStateIssuer
071753949OtherILRAILROAD MEDICARE
036035278MedicaidIL
01616147OtherILBCBS

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 Medicine

State licenses

LicenseStateTypeSpecialty
036035278ILMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1154379386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE",
            "address_2": "SUITE#305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253500",
            "telephone_number": "773-271-4442",
            "fax_number": "708-590-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253500",
            "telephone_number": "773-271-4442",
            "fax_number": "708-590-7148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCHENBAUM",
        "first_name": "M",
        "middle_name": "BARRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036035278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "071753949",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036035278",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01616147",
            "state": "IL"
        }
    ],
    "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 Jul 19, 2016; 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.