NPIMap

Individual provider Active NPI

Michael David Smith, M.D.

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1386637148
Registry record updated Dec 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036078435 Issued in IL
Practice address
600 N Lake Shore Dr
Apt 3301
Chicago, IL 60611
Phone
(312) 371-5200
Fax
(312) 371-5200
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036078435 IL Primary

Addresses

Primary practice location

600 N Lake Shore Dr
Apt 3301
Chicago, IL 60611

Mailing address

600 N Lake Shore Dr
Apt 3301
Chicago, IL 60611
Phone (312) 371-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040102000176 IL Practitioner - Diagnostic Radiology 1153220819 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036078435ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Imaging SC CurrentSince May 1, 2016 Accepting new patients
Potomac Radiology & Imaging Associates Inc Diagnostic Radiology Past Accepting new patients
Achieve Orthopedic Rehabilitation Institute,Inc PastSince Nov 26, 2002 Accepting new patients
Advantage Imaging, LLC Diagnostic Radiology PastSince Aug 28, 2013 Accepting new patients
Rand Imaging Center Past Accepting new patients
Skokie Valley Radiologist Past Accepting new patients
Radiology Imaging of Nebraska, LLC Diagnostic Radiology Past Accepting new patients
Touchstone Imaging of Peoria, LLC Past Accepting new patients
Radiology Imaging Associates, PC Diagnostic Radiology Past Accepting new patients
Diagnostic Imaging Associates Diagnostic Radiology Past Accepting new patients
Scancare Diagnostics LLC PastSince May 1, 2016 Accepting new patients
Touchstone Imaging of Peoria, LLC Past Accepting new patients
Diagnostic Imaging Inc Diagnostic Radiology Past Accepting new patients
Radiology & Nuclear Consultants LTD Diagnostic Radiology Past Accepting new patients
Galilee Medical Center, S.C. PastSince Jan 1, 2014 Accepting new patients

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513296000000",
    "number": "1386637148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N LAKE SHORE DR",
            "address_2": "APT 3301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-371-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N LAKE SHORE DR",
            "address_2": "APT 3301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-371-5200",
            "fax_number": "312-371-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2017-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036078435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.