Ethan Ungchusri

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

036171306 Issued in IL

Practice address

5841 S Maryland Ave
Chicago, IL 60637

Phone

(773) 702-3550

NPI assigned

Apr 12, 2018

Last updated

Sep 21, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

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 2

Specialty

Diagnostic RadiologyAlso: Interventional Radiology

Education

Texas Tech University Health Science Center School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of ChicagoGroup PAC ID 7719899426, shared by 2 NPIs, 1,674 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088
• Uchicago Medicine Northwest Indiana Hospital, Crown Point, IN, CCN 150195
• Franciscan Health Olympia & Chicago Heights Hospital, Olympia Fields, IL, CCN 140172

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

82.45

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment NPD
• University of Chicago

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1477262046
  Medicare reassignment NPD
• University of Chicago

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1821048786

  IN

  Medicare reassignment NPD
• The University of Chicago Medical Center

  dba UCMC Pharmacy Services

  • Community/Retail Pharmacy
  • Calumet City, IL
  • NPI 1255895678
  NPD

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

• Franciscan Health Olympia Fields

  • General Acute Care Hospital
  • Olympia Fields, IL
  • NPI 1588771919
  Care Compare affiliation
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1508956509
  Care Compare affiliation
• Uchicago Medicine Northwest Indiana Inc

  • General Acute Care Hospital
  • Crown Point, IN
  • NPI 1144914532
  Care Compare affiliation

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1437656683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR STE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60637",
            "telephone_number": "773-702-3550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 Dundee Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600622765",
            "country_code": "US",
            "telephone_number": "224-407-4400",
            "fax_number": "224-407-2255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "950 Technology Way Ste 250",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600485366",
            "country_code": "US",
            "telephone_number": "224-407-4400",
            "fax_number": "224-407-2255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5875 E Riverside Blvd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611144937",
            "country_code": "US",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1959 NE Pacific St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981950001",
            "country_code": "US",
            "telephone_number": "206-543-3687",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1959 NE Pacific St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981950001",
            "country_code": "US",
            "telephone_number": "206-543-3687",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1870 W Winchestr Rd Ste 146",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600485359",
            "country_code": "US",
            "telephone_number": "847-584-3959",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "534 Roxbury Rd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611075076",
            "country_code": "US",
            "telephone_number": "847-584-3959",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9410 Calumet Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463210018",
            "country_code": "US",
            "telephone_number": "847-584-3959",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1550 N Randall Rd",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601237876",
            "country_code": "US",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UNGCHUSRI",
        "first_name": "ETHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036171306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vascular & Interventional Radiology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Vascular & Interventional Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.