Individual provider Active NPI

Bezalel Dantz, M.D.

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1316049026
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036102712 Issued in IL
Practice address
1700 W Van Buren St
Suite 500
Chicago, IL 60612-3218
Phone
(312) 563-2875
Fax
(312) 942-3012
NPI assigned
Sep 2, 2006
Last updated
Feb 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-102712 IL
Psychiatry Physician 2084P0800X 036102712 IL Primary

Addresses

Primary practice location

1700 W Van Buren St
Suite 500
Chicago, IL 60612-3218

Mailing address

1700 W Van Buren St
Suite 500
Chicago, IL 60612-3218
Phone (312) 563-2875

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040202000312 IL Practitioner - PsychiatryPractitioner - Internal Medicine 8527961911 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-102712ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
K.a.M Alliance, Inc. Psychiatry CurrentSince Jun 1, 2015 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Mount Sinai Community Foundation Dba Sinai Medical Group CurrentSince Feb 1, 2015 Accepting new patients
Mount Sinai Community Foundation Internal Medicine CurrentSince Feb 1, 2015 Accepting new patients

Locations

2215 W 95th St
#100
Chicago, IL 60643
Phone (773) 239-9600

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

Interoperability endpoints

  • Direct secure messaging: bdantzmd1943@direct.rush.rush-health.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1316049026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W VAN BUREN ST",
            "address_2": "SUITE 500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123218",
            "telephone_number": "312-563-2875",
            "fax_number": "312-942-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W VAN BUREN ST",
            "address_2": "SUITE 500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123218",
            "telephone_number": "312-563-2875",
            "fax_number": "312-942-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTZ",
        "first_name": "BEZALEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-102712",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036102712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.