Individual provider Active NPI

Richard Joseph Fantus, MD

  • Surgical Critical Care Physician
  • Chicago, IL
National Provider Identifier
1457383697
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
036064949 Issued in IL
Practice address
836 W Wellington Ave
Chicago, IL 60657-5147
Phone
(773) 296-7033
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 036064949 IL
Surgical Critical Care Physician 2086S0102X 036064949 IL Primary

Addresses

Primary practice location

836 W Wellington Ave
Chicago, IL 60657-5147

Mailing address

29373 Network PL
Chicago, IL 60673-1293

Other identifiers 1

IdentifierTypeStateIssuer
036064949MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address rfantus237724@direct.myadvocateaurora.org Direct

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
I20061220000411 IL Practitioner - General Surgery 8820062433 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036064949ILMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Oct 1, 2013 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Oct 1, 2013 Accepting new patients

Locations

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

75 Remittance Dr
Dept 6994
Chicago, IL 60675

836 W Wellington Ave
#4813
Chicago, IL 60657
Phone (773) 296-3036

836 W Wellington Ave
Chicago, IL 60657
Phone (773) 296-7054

836 W Wellington Ave
Rm 4813CC
Chicago, IL 60657
Phone (773) 296-5073

75 Remittance Dr
Chicago, IL 60675

29373 Network Pl
Chicago, IL 60673

1301 E 47th St
Chicago, IL 60653
Phone (773) 493-8212

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1457383697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-296-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTUS",
        "first_name": "RICHARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": "036064949",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IL",
            "license": "036064949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036064949",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "836 W Wellington Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606575147",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rfantus237724@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "836 W Wellington Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606575147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.