Active NPI
Renik Delisser, MD, MBA
- Anesthesiology Physician
- Maywood, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 036172716
- Practice address
- 2160 S 1St Ave
Maywood, IL 60153-3328 - Phone
- (708) 216-9000
- NPI assigned
- Apr 4, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 036172716 | IL | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2160 S 1St Ave
Maywood, IL 60153-3328
Mailing address
1 Gustave L Levy PL
Box 1010
New York, NY 10029-6504
Other practice location 1
4440 W 95th St
Oak Lawn, IL 60453-2600
Phone (708) 684-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100398351 | Medicaid | WI |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/Documentsubmission/2_0/Nhinservice/XDRRequest_Service | Other | Ability Network |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | rdelisser418263@direct.myadvocateaurora.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, IL, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Loma Linda University School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
210 Wisconsin American Dr
Fond Du Lac, WI 54937-2999
Phone (920) 907-4800
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Business Administration, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036172716 | IL | MD | Anesthesiology Physician |
| 8632 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loyola University Medical Center | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| G2 Anesthesia PC | Anesthesiology | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Past | Accepting new patients |
Locations (25 of 27)
3803 S Bascom Ave
Ste 204
Campbell, CA 95008
Phone (408) 559-8658
429 Llewellyn Ave
Campbell, CA 95008
Phone (408) 358-5000
3803 S Bascom Ave
Ste 106
Campbell, CA 95008
Phone (408) 249-3840
3803 S Bascom Ave
Ste 100
Campbell, CA 95008
Phone (408) 559-7177
4756 El Camino Real
Los Altos, CA 94022
Phone (650) 445-4724
15780 Los Gatos Blvd
Los Gatos, CA 95032
Phone (408) 358-5000
15195 National Ave
Ste 204
Los Gatos, CA 95032
Phone (408) 356-0988
15195 National Ave
Ste 100
Los Gatos, CA 95032
Phone (408) 356-0454
14601 S Bascom Ave
Ste 100
Los Gatos, CA 95032
Phone (408) 358-6815
555 Knowles Dr
Ste 115
Los Gatos, CA 95032
Phone (408) 374-4400
15195 National Ave
Ste 207
Los Gatos, CA 95032
Phone (408) 356-0431
101 Addison Ave
Palo Alto, CA 94301
Phone (650) 433-8621
400 Forest Ave
Palo Alto, CA 94301
Phone (650) 289-1208
3370 Geary Blvd
San Francisco, CA 94118
Phone (415) 379-7500
2110 Forest Ave
Fl 2
San Jose, CA 95128
Phone (408) 297-3432
2410 Samaritan Dr
Ste 101
San Jose, CA 95124
Phone (408) 369-9798
280 Hospital Pkwy
San Jose, CA 95119
Phone (408) 972-3100
2425 Samaritan Dr
San Jose, CA 95124
Phone (408) 354-2114
133 La Casa Via
Ste 150
Walnut Creek, CA 94598
Phone (925) 210-8400
2021 Ygnacio Valley Rd
Ste H102
Walnut Creek, CA 94598
Phone (866) 678-4320
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
29373 Network Pl
Chicago, IL 60673
500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119
2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400
4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520
Organizations & group practices 8
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.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
- Anesthesiology Physician
- Los Gatos, CA
- NPI 1487214698
-
dba Advocate Medical Group
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
dba Mulcahy Pharmacy
- Community/Retail Pharmacy
- Maywood, IL
- NPI 1184789299
-
- General Practice Physician
- Maywood, IL
- NPI 1336159961
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
-
dba Advocate Christ Medical Center
- General Acute Care Hospital
- Oak Lawn, IL
- NPI 1548375082
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Foster G. McGaw Hospital
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
dba Loyola University Medical Center Cancer Center
- General Acute Care Hospital
- Tinley Park, IL
- NPI 1427752013
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Cudahy, WI
- NPI 1235355983
Hospital
-
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1861447179
-
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1275578064
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771891200000",
"number": "1316300510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 GUSTAVE L LEVY PL",
"address_2": "BOX 1010",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-9000"
}
],
"practiceLocations": [
{
"address_1": "4440 W 95th St",
"address_purpose": "LOCATION",
"city": "Oak Lawn",
"state": "IL",
"postal_code": "604532600",
"country_code": "US",
"telephone_number": "708-684-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DELISSER",
"first_name": "RENIK",
"credential": "MD, MBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-04",
"last_updated": "2026-02-24",
"certification_date": "2026-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036172716",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100398351",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/Documentsubmission/2_0/Nhinservice/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "Ability Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "64 S Price Rd Ste B",
"city": "Brownsville",
"state": "TX",
"country_code": "US",
"postal_code": "785212459",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "4440 W 95th St",
"city": "Oak Lawn",
"state": "IL",
"country_code": "US",
"postal_code": "604532600",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rdelisser418263@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "4440 W 95th St",
"city": "Oak Lawn",
"state": "IL",
"country_code": "US",
"postal_code": "604532600",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.