Individual provider Active NPI

Marilyn May Hallock, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1336110691
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Practice address
1653 W Congress Pkwy
177 Murdock
Chicago, IL 60612-3833
Phone
(312) 942-6909
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ML20008158 WA
Emergency Medicine Physician 207P00000X IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy
177 Murdock
Chicago, IL 60612-3833

Mailing address

8 W Monroe St Apt 1607
Chicago, IL 60603-2451
Phone (206) 349-8897

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
I20070915000026 IL Practitioner - Emergency Medicine 2062506538 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.118742ILMDEmergency Medicine Physician
ML20008158WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Emergency Medicine CurrentSince Oct 1, 2020 Accepting new patients
Rush University Medical Center CurrentSince Oct 1, 2020 Accepting new patients

Locations

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

1653 W Congress Pkwy
#177
Chicago, IL 60612
Phone (312) 947-0229

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

Interoperability endpoints

  • Direct secure messaging: mhallock9761@direct.rush.rush-health.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1336110691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 W MONROE ST APT 1607",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032451",
            "telephone_number": "206-349-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "address_2": "177 MURDOCK",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLOCK",
        "first_name": "MARILYN",
        "middle_name": "MAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "ML20008158",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.