Individual provider Active NPI

Matthew Alexis Ivanovich, M.D.

  • Pulmonary Disease Physician
  • Elgin, IL
National Provider Identifier
1174516314
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036072285 Issued in IL
Practice address
1710 N Randall Rd Ste 260
Elgin, IL 60123-9402
Phone
(847) 931-7900
Fax
(847) 931-1562
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036072285 IL
Pulmonary Disease Physician 207RP1001X 036072285 IL Primary

Addresses

Primary practice location

1710 N Randall Rd Ste 260
Elgin, IL 60123-9402

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other identifiers 1

IdentifierTypeStateIssuer
036072285MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mivanovich236479@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2

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
I20100104000035 IL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 8527109222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1710 N Randall Rd
Elgin, IL 60123-9400
Phone (847) 888-1914

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Nov 9, 2020 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Nov 9, 2020 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients

Locations

27750 W Il Route 22
Ste 240
Barrington, IL 60010
Phone (847) 381-5800

1301 S Barrington Rd
Barrington, IL 60010
Phone (847) 620-4571

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

1710 N Randall Rd
Ste 26
Elgin, IL 60123
Phone (847) 931-7900

1710 N Randall Rd
Elgin, IL 60123
Phone (847) 741-4376

1710 N Randall Rd
Ste 260
Elgin, IL 60123
Phone (847) 931-7900

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

Interoperability endpoints

  • Direct secure messaging: mivanovich236479@direct.myadvocateaurora.org

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.

Hospital & facility affiliations 9

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1174516314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 N RANDALL RD STE 260",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601239402",
            "telephone_number": "847-931-7900",
            "fax_number": "847-931-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANOVICH",
        "first_name": "MATTHEW",
        "middle_name": "ALEXIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036072285",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036072285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036072285",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mivanovich236479@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1710 N Randall Rd Ste 260",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601239402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2",
            "affiliation": "N",
            "address_1": "1710 N Randall Rd Ste 260",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601239402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.