Individual provider Active NPI

Phillip Traylor, M.D.

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1437564804
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
125-065857 Issued in IL
Practice address
251 E Huron St
Chicago, IL 60611-2908
Phone
(312) 926-2000
NPI assigned
Jun 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125-065857 IL
Anesthesiology Physician 207L00000X 125-065857 IL Primary

Addresses

Primary practice location

251 E Huron St
Chicago, IL 60611-2908

Mailing address

1650 W Harrison St
Ste 466
Chicago, IL 60612-3800
Phone (609) 977-4197

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
I20191015003607 IL Practitioner - Anesthesiology 1153667076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Rush Medical College of Rush University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesiologists SCGroup PAC ID 4183512080, 152 clinicians

Practice addresses (Care Compare)

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 942-3138

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesiologists SC Anesthesiology CurrentSince Sep 4, 2019 Accepting new patients

Locations

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1653 W Congress Pkwy
#739
Chicago, IL 60612
Phone (312) 942-3138

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

Organizations & group practices 1

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 2

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": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1437564804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 W HARRISON ST",
            "address_2": "STE 466",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123800",
            "telephone_number": "609-977-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-926-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAYLOR",
        "first_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125-065857",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125-065857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.