Individual provider Active NPI

Michele Bryk, PA

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1316906860
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085001752 Issued in IL
Practice address
675 N Saint Clair St
Galter 21-100
Chicago, IL 60611-5975
Phone
(312) 695-0990
NPI assigned
Mar 22, 2006
Last updated
Jun 23, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001752 IL Primary

Addresses

Primary practice location

675 N Saint Clair St
Galter 21-100
Chicago, IL 60611-5975

Mailing address

680 N Lake Shore Dr
Suite 1000
Chicago, IL 60611-4546
Phone (312) 695-0990

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041217000516 IL Practitioner - Physician Assistant 7618934951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

250 E Superior
2304 Nwmff Prent WMN Hosp
Chicago, IL 60611-2914
Phone (312) 472-3660

250 E Superior St
Chicago, IL 60611-2914

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Oct 11, 2004 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 11, 2004 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

250 E Superior St
#52401
Chicago, IL 60611

675 N Saint Clair St
Ste 21-100
Chicago, IL 60611

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

250 E Superior St
#4420
Chicago, IL 60611
Phone (312) 472-0440

250 E Superior St
#420
Chicago, IL 60611

250 E Superior St
Ste 42305
Chicago, IL 60611
Phone (312) 695-5753

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245715200000",
    "number": "1316906860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-695-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST",
            "address_2": "GALTER 21-100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115975",
            "telephone_number": "312-695-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYK",
        "first_name": "MICHELE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2009-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.