Organization Active NPI

Marius-Nunez Medical Group S C

  • Cardiovascular Disease Physician
  • Berwyn, IL
National Provider Identifier
1235329905
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036077902 Issued in IL
Legal business name
MARIUS-NUNEZ MEDICAL GROUP S C
Practice address
7036 Cermak Rd
Berwyn, IL 60402-2197
Phone
(708) 484-9145
Fax
(708) 484-0441
NPI assigned
Jul 30, 2007
Last updated
Feb 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
Dr. Andres Luis Marius, M.D.
Title
President
Phone
(708) 484-9145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 036077902 IL Primary

Addresses

Primary practice location

7036 Cermak Rd
Berwyn, IL 60402-2197

Mailing address

7036 Cermak Rd
Berwyn, IL 60402-2197
Phone (708) 484-9145

Other identifiers 2

IdentifierTypeStateIssuer
1607253OtherILBLUE CROSS BLUE SHIELD
036077902MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051229000326 IL Part B Supplier - Clinic/Group Practice 3779505193 Receives reassigned benefits from 1 practitioner
Practice locations: Berwyn, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1235329905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7036 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022197",
            "telephone_number": "708-484-9145",
            "fax_number": "708-484-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7036 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022197",
            "telephone_number": "708-484-9145",
            "fax_number": "708-484-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIUS-NUNEZ MEDICAL GROUP S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "MARIUS",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-484-9145",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036077902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1607253",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036077902",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.