Active NPI
Mark Jay Bailin, M.D.
- General Practice Physician
- Chicago, IL
National Provider Identifier
1609068402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 036-069-383
- Practice address
- 6238 N Magnolia Av.
Garden Or Basement Apt.
Chicago, IL 60660-1945 - Phone
- (773) 262-2647
- Fax
- (773) 262-2647
- NPI assigned
- Aug 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 036-069-383 | IL | Primary |
| Occupational Medicine Physician | 2083X0100X | 036-069-383 | IL | |
| Emergency Medicine Physician | 207P00000X | 036-069-383 | IL | |
| Hospitalist Physician | 208M00000X | 036-069-383 | IL | |
| Interventional Pain Medicine Physician | 208VP0014X | 036069383 | IL | |
| Adult Medicine Physician | 207QA0505X | 036069383 | IL |
Addresses
Primary practice location
6238 N Magnolia Av.
Garden Or Basement Apt.
Chicago, IL 60660-1945
Mailing address
6238 N Magnolia Av.
Garden Or Basement Apt.
Chicago, IL 60660-1945
Phone (773) 262-2647
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-069-383 | IL | MD | Occupational Medicine Physician |
| 036069383 | IL | MD | Interventional Pain Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313712000000",
"number": "1609068402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6238 N MAGNOLIA AV.",
"address_2": "GARDEN OR BASEMENT APT.",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606601945",
"telephone_number": "773-262-2647",
"fax_number": "773-262-2647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6238 N MAGNOLIA AV.",
"address_2": "GARDEN OR BASEMENT APT.",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606601945",
"telephone_number": "773-262-2647",
"fax_number": "773-262-2647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILIN",
"first_name": "MARK",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-15",
"last_updated": "2011-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IL",
"license": "036-069-383",
"primary": true
},
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "IL",
"license": "036-069-383",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036-069-383",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036-069-383",
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "IL",
"license": "036069383",
"primary": false
},
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "IL",
"license": "036069383",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.