Individual provider Active NPI

Brian Myers

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1619997293
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036-113629 Issued in IL
Practice address
1653 W Congress Pkwy
735 Jelke Anesthesia Department
Chicago, IL 60612-3833
Phone
(312) 942-6504
Fax
(312) 942-5773
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036-113629 IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy
735 Jelke Anesthesia Department
Chicago, IL 60612-3833

Mailing address

1653 W Congress Pkwy
735 Jelke Anesthesia Department
Chicago, IL 60612-3833
Phone (312) 942-6504

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
I20051020000743 IL Practitioner - Anesthesiology 7214953090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Ohio University, College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesiologists SCGroup PAC ID 4183512080, 152 clinicians

Practice addresses (Care Compare)

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 942-3138

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-113629ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesiologists SC Anesthesiology CurrentSince Aug 1, 2005 Accepting new patients
Rush University Medical Center Past Accepting new patients

Locations

1653 W Congress Pkwy
#739
Chicago, IL 60612
Phone (312) 942-3138

1653 W Congress Pkwy
#735
Chicago, IL 60612
Phone (312) 942-6504

1725 W Harrison St
Ste 556
Chicago, IL 60612
Phone (312) 563-2880

845 N Michigan Ave
Ste 985W
Chicago, IL 60611
Phone (312) 521-5500

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

2011 York Rd
Ste 3000
Oak Brook, IL 60523
Phone (414) 732-2577

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1619997293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "address_2": "735 JELKE ANESTHESIA DEPARTMENT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-6504",
            "fax_number": "312-942-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "address_2": "735 JELKE ANESTHESIA DEPARTMENT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-6504",
            "fax_number": "312-942-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036-113629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.