Individual provider Active NPI

Michelle Bene Bain, M.D.

  • Pediatric Dermatology Physician
  • Chicago, IL
National Provider Identifier
1548377252
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Dermatology PhysicianTaxonomy code 207NP0225X
Practice address
808 S Wood St RM 376
Chicago, IL 60612-7300
Phone
(312) 996-6966
Fax
(312) 996-1188
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dermatology Physician 207NP0225X IL Primary

Addresses

Primary practice location

808 S Wood St RM 376
Chicago, IL 60612-7300

Mailing address

4500 W Berteau Ave
Chicago, IL 60641-1908
Phone (773) 283-3677

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
I20101111000768 IL Practitioner - Dermatology 2668667007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1740 W Taylor St
Chicago, IL 60612-7232

1801 W Taylor St
Chicago, IL 60612-4795

7600 W College Dr
Palos Heights, IL 60463-1001
Phone (708) 923-9772

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions33
Removal or shaving of skin growth1-10
Skin biopsy11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-060916ILMDPediatric Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jan 1, 1988 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jan 1, 1988 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700

1740 W Taylor St
Ste 1400
Chicago, IL 60612
Phone (312) 996-3900

808 S Wood St
Rm 376
Chicago, IL 60612
Phone (312) 996-6966

7600 W College Dr
Palos Heights, IL 60463
Phone (708) 361-0600

Interoperability endpoints

  • Direct secure messaging: mbain16871@uihealth.direct-ci.com

Organizations & group practices 4

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 1

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548377252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 W BERTEAU AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411908",
            "telephone_number": "773-283-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S WOOD ST RM 376",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127300",
            "telephone_number": "312-996-6966",
            "fax_number": "312-996-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIN",
        "first_name": "MICHELLE",
        "middle_name": "BENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.