Active NPI
Marius-Nunez Medical Group S C
- Cardiovascular Disease Physician
- Berwyn, IL
National Provider Identifier
1235329905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 036077902
- 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, 2024
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1607253 | Other | IL | BLUE CROSS BLUE SHIELD |
| 036077902 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & 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.