Macumber Medical LTD

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

Legal business name

MACUMBER MEDICAL LTD

Doing business as

Advanced Vein Center

Practice address

3114 W Irving Park Rd Ste 1W
Chicago, IL 60618-3435

Phone

(833) 388-7669

Fax

(833) 388-7669

NPI assigned

Apr 1, 2020

Last updated

Nov 28, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Macumber, MDNPI 1598805830

Title

Owner

Phone

(773) 220-0376

Specialties & licenses 2

Addresses

Other names 1

• Advanced Vein Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Macumber, MD

  • Phlebology Physician
  • Meridian, ID
  • NPI 1598805830

  IL

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669593600000",
    "number": "1407484645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 W IRVING PARK RD STE 1W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183435",
            "telephone_number": "833-388-7669",
            "fax_number": "833-388-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 W IRVING PARK RD STE 1W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183435",
            "telephone_number": "833-388-7669",
            "fax_number": "833-388-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACUMBER MEDICAL LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-01",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A",
        "authorized_official_last_name": "MACUMBER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-220-0376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "azul.cohlmia@chicagodvt.com",
            "affiliation": "N",
            "endpointDescription": "G suite business",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3114 W Irving Park Rd Ste 1W",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606183435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Advanced Vein Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Constance Sue Macqueen, OD
• Frederick J Macrae, L.C.S.W.
• Attilio Macrito, D.O.
• Sarah Macrowski Macaraeg, PT, DPT
• Karolina Maculewicz
• Ian Robert Macumber, M.D.
• Michelle Lea Macy, MD
• Samuel Thomas Macy, PSYD
• Jo Anne Maczulski, OTR L
• Shreshtha Madaan, M.S.

• Phlebology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Phlebology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.