John Maddalozzo, MD

Primary specialty

Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X

License

036-065457 Issued in IL

Practice address

225 E. Chicago Ave., #25
Ann & Robert H. Lurie Children'S Hospital of Chicago
Chicago, IL 60611-2605

Phone

(312) 227-6230

NPI assigned

Sep 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

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.

• Lurie Children'S Medical Group, LLC

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1992758544
  NPD (past)

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1609862267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E. CHICAGO AVE., #25",
            "address_2": "ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112605",
            "telephone_number": "312-227-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E. CHICAGO AVE., #25",
            "address_2": "ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112605",
            "telephone_number": "312-227-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDALOZZO",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "IL",
            "license": "036-065457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "1627123",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2386216",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065457",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Lucia L Madariaga
• Sreekumar Madassery, M.D.
• Juliana V Maday, RDN
• Michael George Maday, MD
• Anirudh Maddali
• Allyn Grace Madden, PA-C
• Brian A Madden, M.D.
• Carlendia Madden
• Jasmyn V Madden, RN,BSN,MSN
• Jordan Roberta Madden

• Pediatric Otolaryngology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatric Otolaryngology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.