Individual provider Active NPI

Robert W Marvin, M.D.

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1215940424
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036099622 Issued in IL
Practice address
2740 W Foster Ave Ste 113
Chicago, IL 60625-3547
Phone
(773) 293-5300
Fax
(773) 293-5346
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036099622 IL Primary

Addresses

Primary practice location

2740 W Foster Ave Ste 113
Chicago, IL 60625-3547

Mailing address

2740 W Foster Ave Ste 113
Chicago, IL 60625-3547
Phone (773) 293-5300

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
I20110114000474 IL Practitioner - Psychiatry 4880883396 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Wisconsin School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

2740 W Foster Ave
Chicago, IL 60625-3547

5140 N California
Suite G600
Chicago, IL 60625-3645
Phone (773) 989-3803

5140 N California Ave
Chicago, IL 60625-3645

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jun 30, 2023 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Mar 14, 2000 Accepting new patients
Endeavor Health Medical Group CurrentSince Jun 30, 2023 Accepting new patients
The Board of Trustees of the University of Illinois Psychiatry CurrentSince Mar 14, 2000 Accepting new patients

Locations

7825 Solution Ctr
Chicago, IL 60677

912 S Wood St
Chicago, IL 60612
Phone (312) 996-2200

9532 Eagle Way
Chicago, IL 60678

2740 W Foster Ave
Ste 113
Chicago, IL 60625
Phone (773) 275-7900

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

Organizations & group practices 4

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1215940424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE STE 113",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253547",
            "telephone_number": "773-293-5300",
            "fax_number": "773-293-5346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE STE 113",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253547",
            "telephone_number": "773-293-5300",
            "fax_number": "773-293-5346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARVIN",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036099622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.