Igor Prus, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

036.136049 Issued in IL

Practice address

5215 N California Ave Ste 804
Chicago, IL 60625-7014

Phone

(773) 907-7750

Fax

(773) 907-7760

NPI assigned

Jun 21, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Family PracticeAlso: Sports Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Hospital Hospital, Chicago, IL, CCN 140114
• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: iprus275883@direct.northshore.org

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.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment NPD
• Swedish Covenant Management Services, Inc.

  dba Swedish Covenant Medical Group

  • Obstetrics & Gynecology Physician
  • Chicago, IL
  • NPI 1760432348
  Medicare reassignment
• Advocate Health and Hospitals Corporation

  dba Advocate Children's Hospital

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Endeavor Health Clinical Operations

  dba Endeavor Health Evanston Hospital

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation
• Swedish Covenant Health

  dba Endeavor Health Swedish Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1831151257
  Care Compare affiliation

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1205199502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE STE 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253547",
            "telephone_number": "773-878-8200",
            "fax_number": "773-298-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N CALIFORNIA AVE STE 804",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257014",
            "telephone_number": "773-907-7750",
            "fax_number": "773-907-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUS",
        "first_name": "IGOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-21",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.136049",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036.136049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iprus275883@direct.northshore.org",
            "affiliation": "N",
            "address_1": "5215 N California Ave Ste 804",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606257014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nayesha Adia Pruitt, LPC
• Nikiya Pruitt
• Peter Burton Pruitt, M.D.
• Shervylle Pruitt
• Bozena Prus, PA
• Jaroslaw Prus, P.T.
• Nicholas Marek Prus
• James Prusha, RD
• Jacqueline M Prusinski, ATC
• Olivia Katherine Pruss, MD

• Sports Medicine (Family Medicine) Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Sports Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.

Verify at the official NPI Registry.