Individual provider Active NPI

Yulia M Demidovich, MD

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1306897475
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036109413 Issued in IL
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

Updated by the provider on Dec 22, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
009906261OOtherHUMANA
1306897475MedicaidWI
34537900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TN2 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
I20150831000013 IL Practitioner - Anesthesiology 5698731974 Reassigns benefits to 4 organizations
I20250107001910 TN Practitioner - Anesthesiology 5698731974

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
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

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

LicenseStateTypeSpecialty
036109413ILMDAnesthesiology Physician
46973-020WIMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ambulatory Anesthesiologists of Chicago, LLC Anesthesiology CurrentSince Jan 30, 2019 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 CurrentSince Jul 1, 2015 Accepting new patients
The Board of Trustees of the University of Illinois Anesthesiology CurrentSince Jul 1, 2015 Accepting new patients
The University of Chicago Medical Center CurrentSince Aug 16, 2019 Accepting new patients
The University of Chicago Medical Center CurrentSince Aug 16, 2019 Accepting new patients
University of Chicago CurrentSince Aug 16, 2019 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.