Individual provider Active NPI

Avram I. Avramov, M.D.

  • Anesthesiology Physician
  • Oak Park, IL
National Provider Identifier
1194769216
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036094013 Issued in IL
Practice address
3 Erie CT
Oak Park, IL 60302-2519
Phone
(708) 383-6200
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036094013 IL Primary
Interventional Pain Medicine Physician 208VP0014X 036094013 IL

Addresses

Primary practice location

3 Erie CT
Oak Park, IL 60302-2519

Mailing address

185 Penny Ave
East Dundee, IL 60118-1454
Phone (847) 836-7015

Other identifiers 1

IdentifierTypeStateIssuer
036094013MedicaidIL

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

Practice roles

OrganizationSpecialtyStatusNew patients
Parkway Anesthesia Associates LLC Anesthesiology CurrentSince May 17, 2024 Accepting new patients
Coastal Surgery Center, LLC Past Accepting new patients
Professional Anesthesia, S.C. Anesthesiology PastSince Sep 1, 2008 Accepting new patients

Locations

495 Jack Martin Blvd
Ste 1
Brick, NJ 08724
Phone (732) 836-9800

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1194769216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 PENNY AVE",
            "city": "EAST DUNDEE",
            "state": "IL",
            "postal_code": "601181454",
            "telephone_number": "847-836-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ERIE CT",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022519",
            "telephone_number": "708-383-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVRAMOV",
        "first_name": "AVRAM",
        "middle_name": "I.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036094013",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036094013",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094013",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; 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.