Active NPI
Milena Ivanova, M.D.
- Diagnostic Radiology Physician
- Maywood, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036139052
- Practice address
- 2160 S 1St Ave
Maywood, IL 60153-3328 - Phone
- (708) 216-9000
- NPI assigned
- May 29, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | D74734 | MD | |
| Diagnostic Radiology Physician | 2085R0202X | 257386 | MA | |
| Diagnostic Radiology Physician | 2085R0202X | 66154 | WI | |
| Diagnostic Radiology Physician | 2085R0202X | 036139052 | IL | Primary |
Addresses
Primary practice location
2160 S 1St Ave
Maywood, IL 60153-3328
Mailing address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 058302200 | Medicaid | MD | |
| 1174724264 | Medicaid | WI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mivanova142243@direct.luhs.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Miami, LM Miller School of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000
Hospital & facility affiliations
- Loyola University Medical Center
- Loyola Gottlieb Memorial Hospital
- Macneal Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D74734 | MD | MD | Diagnostic Radiology Physician |
| 66154 | WI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loyola University Medical Center | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| DRS. Massaro & Kalenak S C | Current | Accepting new patients | |
| City of Hope Medical Group of Illinois PLLC | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Diagnostic Radiology | Current | Accepting new patients |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| The Medical College of Wisconsin, Inc. | Current | Accepting new patients | |
| Johns Hopkins University | Diagnostic Radiology | Past | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
2361 Paysphere Cir
Chicago, IL 60674
Phone (847) 746-4358
1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300
500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119
1000 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6150
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
1000 N Westmoreland Rd
Fl 3
Lake Forest, IL 60045
Phone (847) 535-6615
2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400
2520 Elisha Ave
Zion, IL 60099
Phone (800) 322-9183
W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060
2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000
13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000
1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451
Organizations & group practices 11
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.
-
- General Practice Physician
- Maywood, IL
- NPI 1336159961
-
- Specialist
- Zion, IL
- NPI 1548258072
-
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
Diagnostic Radiology
-
- Internal Medicine Physician
- Menomonee Falls, WI
- NPI 1568787448
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
-
- Community/Retail Pharmacy
- Maywood, IL
- NPI 1184789299
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
-
- Ophthalmology Physician
- Milwaukee, WI
- NPI 1558482364
-
- Durable Medical Equipment & Medical Supplies
- Wauwatosa, WI
- NPI 1154947224
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Berwyn, IL
- NPI 1295710580
-
- General Acute Care Hospital
- Melrose Park, IL
- NPI 1831170232
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
- General Acute Care Hospital
- Tinley Park, IL
- NPI 1427752013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653091200000",
"number": "1174724264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVANOVA",
"first_name": "MILENA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-29",
"last_updated": "2022-05-21",
"certification_date": "2022-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MD",
"license": "D74734",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "257386",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WI",
"license": "66154",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036139052",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "058302200",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1174724264",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mivanova142243@direct.luhs.org",
"affiliation": "N",
"endpointDescription": "mivanova142243@direct.luhs.org",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2160 S 1st Ave",
"city": "Maywood",
"state": "IL",
"country_code": "US",
"postal_code": "601533328",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2022; 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.