Max D Koenigsberg, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036-060719 Issued in IL

Practice address

836 W Wellington Ave
Chicago, IL 60657-5147

Phone

(773) 296-7054

Fax

(773) 296-7818

NPI assigned

Jun 27, 2006

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

Other identifiers 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Advocate North Side Health Network

  • Clinic/Center
  • Chicago, IL
  • NPI 1780788323
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1295762250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N. LAKE SHORE DR",
            "address_2": "19 G",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606106602",
            "telephone_number": "312-642-5662",
            "fax_number": "312-944-7185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-296-7054",
            "fax_number": "773-296-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIGSBERG",
        "first_name": "MAX",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-060719",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "036-060719",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-060719",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darren Eugene Koenig, O.D.
• Peter R Koenig, M.D.
• Russell Koenig, MS
• Shelby Koenig
• Lisa Anne Koenigsberg, MS CCC-SLP
• Sarah Catherine Koenigsfeld, PA
• Jonna Koenitzer
• Macy E Koepke, OD
• Rebecca J Koeppen, MA, LPC
• Kendra Koerner, M.S.CCC-SLP

• Emergency Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.