Individual provider Active NPI

Michael Tandlich, MD

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1285260273
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
1285260273 Issued in IL
Practice address
251 E Huron St
Chicago, IL 60611-3055
Phone
(312) 926-2000
NPI assigned
Mar 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 1285260273 IL Primary
Emergency Medicine Physician 207P00000X 01093276A IN
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

251 E Huron St
Chicago, IL 60611-3055

Mailing address

251 E Huron St
Chicago, IL 60611-3055
Phone (312) 926-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231016000981 IL Practitioner - Emergency Medicine 2567884208 Reassigns benefits to 2 organizations
I20241011002816 IN Practitioner - Emergency Medicine 2567884208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Florida State University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 661-5111

600 Grant St
Gary, IN 46402-6001
Phone (219) 886-4000

Hospital & facility affiliations

  • Methodist Hospitals Inc Hospital, Gary, IN, CCN 150002
  • St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

Merit-based Incentive Payment System (MIPS)

Final score
87.08 of 100Reported as group
Quality
86.25
Improvement activities
40
Cost
77.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1285260273ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Sep 15, 2024 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Apr 1, 2026 Accepting new patients
Freeport Memorial Hospital CurrentSince Sep 1, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Sep 15, 2024 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Apr 1, 2026 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2200 E Washington St
Bloomington, IL 61701
Phone (309) 662-3311

1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105

421 W Exchange St
Freeport, IL 61032
Phone (815) 599-7300

8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1584748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1285260273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113055",
            "telephone_number": "312-926-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113055",
            "telephone_number": "312-926-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANDLICH",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-21",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "1285260273",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01093276A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.