David L. Mutchnik, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

036038702 Issued in IL

Practice address

9669 Kenton Ave
Suite 608
Skokie, IL 60076-1266

Phone

(847) 677-4111

Fax

(847) 677-3343

NPI assigned

Mar 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• United Shockwave Services, LTD.

  • Ambulatory Surgical Clinic/Center
  • La Grange, IL
  • NPI 1336526219
  NPD
• United Shockwave Services, LTD.

  • Urology Physician
  • Park Ridge, IL
  • NPI 1497132377
  NPD

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1417917006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE",
            "address_2": "SUITE 608",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761266",
            "telephone_number": "847-677-4111",
            "fax_number": "847-677-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE",
            "address_2": "SUITE 608",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761266",
            "telephone_number": "847-677-4111",
            "fax_number": "847-677-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTCHNIK",
        "first_name": "DAVID",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036038702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036038702",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "davidmutchnik@uropart.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "9669 Kenton Ave",
            "address_2": "Suite 608",
            "city": "Skokie",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600761266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sheryl Murray, MD
• Camelia Antoinette Musleh, MD
• Rachel Taylor Muss, LPC
• Veronica Mussay, PA-C
• Jennifer Mussen, MOT, OTR/L
• Steven E. Mutchnik, M.D.
• Priscilla Roche Mutharasan, M.D.
• Chethra Kala Muthiah, M.D.
• Sara Muttar
• Alice Wanjiru Mwaura, DNP

• Urology Physician in Skokie, IL
• Providers in Skokie, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.