Active NPI
Arthur Charles Nielsen III, M.D.
- Psychiatry Physician
- Chicago, IL
National Provider Identifier
1376550822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Practice address
- 333 E Ontario St
Suite 4209B
Chicago, IL 60611-4804 - Phone
- (312) 649-0570
- Fax
- (847) 441-7196
- NPI assigned
- Aug 1, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | IL | Primary |
Addresses
Primary practice location
333 E Ontario St
Suite 4209B
Chicago, IL 60611-4804
Mailing address
333 E Ontario St
Suite 4209B
Chicago, IL 60611-4804
Phone (312) 649-0570
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0021609228 | Other | IL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Previously, effective Aug 14, 2016 through Aug 14, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-060262 | IL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376550822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 E ONTARIO ST",
"address_2": "SUITE 4209B",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606114804",
"telephone_number": "312-649-0570",
"fax_number": "847-441-7196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 E ONTARIO ST",
"address_2": "SUITE 4209B",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606114804",
"telephone_number": "312-649-0570",
"fax_number": "847-441-7196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIELSEN",
"first_name": "ARTHUR",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0021609228",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.