Individual provider Active NPI

Nicholas John Skertich, M.D.

  • Surgery Physician
  • Chicago, IL
National Provider Identifier
1417319377
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036163819 Issued in IL
Practice address
1750 W Harrison St
Suite 785
Chicago, IL 60612-3825
Phone
(312) 942-6510
NPI assigned
Mar 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 036163819 IL Primary

Addresses

Primary practice location

1750 W Harrison St
Suite 785
Chicago, IL 60612-3825

Mailing address

1750 W Harrison St
Suite 785
Chicago, IL 60612-3825
Phone (312) 942-6510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230630001908 IL Practitioner - General Surgery 7214229228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1725 W Harrison St
Suite 818
Chicago, IL 60612-3895
Phone (312) 942-5500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Surgery CurrentSince Jul 28, 2023 Accepting new patients
Rush University Medical Center Surgery CurrentSince Jul 28, 2023 Accepting new patients

Locations

2020 Ogden Ave
Ste 400
Aurora, IL 60504
Phone (630) 375-2925

1725 W Harrison St
Ste 818
Chicago, IL 60612
Phone (312) 942-4444

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1625 N Harlem Ave
Chicago, IL 60707
Phone (312) 256-8583

516 S Loomis St
Chicago, IL 60607
Phone (717) 975-6402

1750 W Harrison St
Ste 785
Chicago, IL 60612
Phone (312) 942-6510

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

2011 York Rd
Ste 2000A
Oak Brook, IL 60523
Phone (312) 947-7546

5851 W 95th St
Ste 110
Oak Lawn, IL 60453
Phone (708) 660-2364

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1417319377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 W HARRISON ST",
            "address_2": "SUITE 785",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123825",
            "telephone_number": "312-942-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 W HARRISON ST",
            "address_2": "SUITE 785",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123825",
            "telephone_number": "312-942-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKERTICH",
        "first_name": "NICHOLAS",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036163819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.