Individual provider Active NPI

Erik Dennis McClure, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
National Provider Identifier
1396992236
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
125-051161 Issued in IL
Practice address
255 W 69TH St
Chicago, IL 60621-3767
Phone
(773) 224-5900
Fax
(773) 224-7157
NPI assigned
Aug 22, 2008
Last updated
Oct 29, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 125-051161 IL Primary

Addresses

Primary practice location

255 W 69TH St
Chicago, IL 60621-3767

Mailing address

401 N Michigan Ave
Suite 1200
Chicago, IL 60611-4264
Phone (312) 635-0973

Other identifiers 3

IdentifierTypeStateIssuer
P01251475OtherILRR MEDICARE
036.127953OtherILLICENSE NO
036127953MedicaidIL

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
125-051161ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Merrillville Pain Relief Center PC PastSince Sep 19, 2011 Accepting new patients
Rehab and Health, LLC Physical Medicine & Rehabilitation PastSince Jan 2, 2017 Accepting new patients

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, 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": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1396992236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N MICHIGAN AVE",
            "address_2": "SUITE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114264",
            "telephone_number": "312-635-0973",
            "fax_number": "813-290-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W 69TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213767",
            "telephone_number": "773-224-5900",
            "fax_number": "773-224-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "ERIK",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-22",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "125-051161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01251475",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NO",
            "identifier": "036.127953",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036127953",
            "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 Oct 29, 2015; 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.