Edward H Mkrdichian, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

036063585 Issued in IL

Practice address

4501 N Winchester Ave
3Rd FL
Chicago, IL 60640

Phone

(773) 250-0500

Fax

(773) 250-0497

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Chicago Institute of Neurosurgery & Neuroresearch

  • Neurological Surgery Physician
  • Chicago, IL
  • NPI 1326099391
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225411200000",
    "number": "1477521607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 N WINCHESTER AVE",
            "address_2": "3RD FL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60640",
            "telephone_number": "773-250-0500",
            "fax_number": "773-250-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 N WINCHESTER AVE",
            "address_2": "3RD FL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60640",
            "telephone_number": "773-250-0500",
            "fax_number": "773-250-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MKRDICHIAN",
        "first_name": "EDWARD",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036063585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360635851",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• MK Counseling and Wellness, PLLC
• MK Dental Inc
• MK Home Healthcare LLC
• MK Ortho Equipment, LLC
• MKM Therapy PLLC
• Mark Mkrdichian, D.D.S.
• Rebecca Rose Mladucky, PT, DPT
• MLM Massage LLC
• Laura Mlnarik, PT
• Michael Aaron Mlnarik, LDN

• Neurological Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Neurological Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.