Active NPI
Yulia M Demidovich, MD
- Anesthesiology Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 036109413
- Practice address
- 1740 W Taylor St
3200W; MC 515
Chicago, IL 60612-7232 - Phone
- (312) 996-4020
- Fax
- (312) 996-4019
- NPI assigned
- May 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 46973 | WI | |
| Anesthesiology Physician | 207L00000X | 036109413 | IL | Primary |
| Pediatric Anesthesiology Physician | 207LP3000X | 036109413 | IL | |
| Pediatric Anesthesiology Physician | 207LP3000X | 46973-020 | WI |
Addresses
Primary practice location
1740 W Taylor St
3200W; MC 515
Chicago, IL 60612-7232
Mailing address
1740 W Taylor St
3200W; MC 515
Chicago, IL 60612-7232
Phone (312) 996-4020
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009906261O | Other | HUMANA | |
| 1306897475 | Medicaid | WI | |
| 34537900 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of Nebraska College of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (888) 824-0200
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036109413 | IL | MD | Anesthesiology Physician |
| 46973-020 | WI | MD | Pediatric Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ambulatory Anesthesiologists of Chicago, LLC | Anesthesiology | Current | Accepting new patients |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Anesthesiology | Current | Accepting new patients |
| The University of Chicago Medical Center | Current | Accepting new patients | |
| The University of Chicago Medical Center | Current | Accepting new patients | |
| University of Chicago | Current | Accepting new patients |
Locations
150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061
1740 W Taylor St
#3200W
Chicago, IL 60612
Phone (312) 996-4020
7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290
1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582
7732 Solutions Ctr
Chicago, IL 60677
1740 W Taylor St
#3200
Chicago, IL 60612
Phone (312) 996-4021
1653 W Congress Pkwy
#739
Chicago, IL 60612
Phone (312) 942-3138
1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138
60 E Delaware Pl
Fl 15
Chicago, IL 60611
Phone (312) 440-5150
350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500
120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700
1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150
27650 Ferry Rd
Warrenville, IL 60555
Phone (630) 225-2345
Interoperability endpoints
- ydemidovich225033@uchospital.direct-ci.com
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.
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1821048786
-
- Anesthesiology Physician
- Chicago, IL
- NPI 1659306272
-
- Anatomic Pathology Physician
- Chicago, IL
- NPI 1386863819
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1033218128
-
dba Occupational Health Service Institute (OHSI)
- Occupational Medicine Physician
- Chicago, IL
- NPI 1043727571
-
dba University of Illinois Medical Center at Chicago
- Internal Medicine Physician
- Chicago, IL
- NPI 1942244645
Anesthesiology
-
dba UCMC Pharmacy Services
- Community/Retail Pharmacy
- Calumet City, IL
- NPI 1255895678
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1508956509
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450742400000",
"number": "1306897475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1740 W TAYLOR ST",
"address_2": "3200W; MC 515",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127232",
"telephone_number": "312-996-4020",
"fax_number": "312-996-4019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 W TAYLOR ST",
"address_2": "3200W; MC 515",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127232",
"telephone_number": "312-996-4020",
"fax_number": "312-996-4019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMIDOVICH",
"first_name": "YULIA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-13",
"last_updated": "2015-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WI",
"license": "46973",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036109413",
"primary": true
},
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "IL",
"license": "036109413",
"primary": false
},
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "WI",
"license": "46973-020",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "009906261O",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306897475",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34537900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.