Individual provider Active NPI

Manucher Michael Forutan, MD

  • Orthopaedic Surgery Physician
  • Naperville, IL
National Provider Identifier
1336353671
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Practice address
600 S Washington St
Suite 300
Naperville, IL 60540-6667
Phone
(630) 717-7000
Fax
(630) 717-7011
NPI assigned
May 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X IL Primary

Addresses

Primary practice location

600 S Washington St
Suite 300
Naperville, IL 60540-6667

Mailing address

PO Box 3911
Lisle, IL 60532-8911
Phone (630) 717-7000

Other identifiers 3

IdentifierTypeStateIssuer
DC6584OtherMEDICARE RR
P00182546OtherMEDICARE RR
4029503OtherAETNA

Other names 1

  • M Michael Forutan Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036051102ILMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
M Michael Forutan MD SC Orthopaedic Surgery PastSince Nov 28, 1978 Accepting new patients

Organizations & group practices 1

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336353671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3911",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605328911",
            "telephone_number": "630-717-7000",
            "fax_number": "630-717-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S WASHINGTON ST",
            "address_2": "SUITE 300",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406667",
            "telephone_number": "630-717-7000",
            "fax_number": "630-717-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORUTAN",
        "first_name": "MANUCHER",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "DC6584",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00182546",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4029503",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M",
            "last_name": "FORUTAN",
            "middle_name": "MICHAEL",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.