Individual provider Active NPI

Renik Delisser, MD, MBA

  • Anesthesiology Physician
  • Maywood, IL
National Provider Identifier
1316300510
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036172716 Issued in IL
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

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
100398351MedicaidWI

Electronic endpoints 3

TypeEndpointUseAffiliation
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, WI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20210309000669 CA Practitioner - Anesthesiology 5092001586 Reassigns benefits to 1 organization
I20241220001765 IL Practitioner - Anesthesiology 5092001586
I20260220000871 WI Practitioner - Anesthesiology 5092001586 Reassigns benefits to 1 organization

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
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

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

LicenseStateTypeSpecialty
036172716ILMDAnesthesiology Physician
8632GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Dec 1, 2024 Accepting new patients
Loyola University Medical Center CurrentSince Dec 1, 2024 Accepting new patients
G2 Anesthesia PC Anesthesiology CurrentSince Apr 15, 2022 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 12, 2026 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 12, 2026 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.

Hospital & facility affiliations 5

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": "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

Verify at the official NPI Registry.