Active NPI
Brock David Andreatta, MD
- Anesthesiology Physician
- Maywood, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 036.124279
- Practice address
- 2160 S 1St Ave Ste 3102
Maywood, IL 60153-3328 - Phone
- (708) 216-8777
- NPI assigned
- May 8, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 35390 | WV | |
| Anesthesiology Physician | 207L00000X | MD61616246 | WA | |
| Anesthesiology Physician | 207L00000X | 036.124279 | IL | Primary |
Addresses
Primary practice location
2160 S 1St Ave Ste 3102
Maywood, IL 60153-3328
Mailing address
2160 S 1St Ave Ste 3102
Maywood, IL 60153-3328
Phone (708) 216-8777
Other practice location 1
800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone (304) 388-5432
Other practice location 2
3200 MacCorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432
Other practice location 3
501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432
Other practice location 4
1306 Kanawha Blvd E
Charleston, WV 25301-3001
Phone (304) 388-1800
Other practice location 5
1220 Lee St E
Charleston, WV 25301-1863
Phone (304) 388-1800
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bandreatta33962@direct.luhs.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, WA, WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Ohio State University College of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.124279 | IL | MD | Anesthesiology Physician |
| MD61616246 | WA | MD | Anesthesiology Physician |
| 35390 | WV | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charleston Area Medical Center, Inc. | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Charleston Area Medical Center Inc | Current | Accepting new patients | |
| Providence Health & Service- Washington | Anesthesiology | Current | Accepting new patients |
Locations
500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119
2160 S 1st Ave
Bldg 101
Maywood, IL 60153
Phone (708) 216-8785
2160 S 1st Ave
Ste 3102
Maywood, IL 60153
Phone (708) 216-8777
2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400
5633 N Lidgerwood St
Spokane, WA 99208
Phone (509) 482-0111
101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181
3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550
1306 Kanawha Blvd E
Charleston, WV 25301
Phone (304) 343-4371
800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550
501 Morris St
Charleston, WV 25301
Phone (304) 348-6293
Organizations & group practices 6
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.
-
- General Practice Physician
- Maywood, IL
- NPI 1336159961
-
- General Acute Care Hospital
- Charleston, WV
- NPI 1124248752
-
- Anesthesiology Physician
- Spokane, WA
- NPI 1508118555
-
- Community/Retail Pharmacy
- Maywood, IL
- NPI 1184789299
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
- Multi-Specialty Clinic/Center
- Belpre, OH
- NPI 1588422547
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
- General Acute Care Hospital
- Tinley Park, IL
- NPI 1427752013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761177600000",
"number": "1629245709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE STE 3102",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-8777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE STE 3102",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-8777"
}
],
"practiceLocations": [
{
"address_1": "800 Pennsylvania Ave",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "WV",
"postal_code": "253023351",
"country_code": "US",
"telephone_number": "304-388-5432",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3200 MacCorkle Ave SE",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "WV",
"postal_code": "253041227",
"country_code": "US",
"telephone_number": "304-388-5432",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "501 Morris St",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "WV",
"postal_code": "253011326",
"country_code": "US",
"telephone_number": "304-388-5432",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1306 Kanawha Blvd E",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "WV",
"postal_code": "253013001",
"country_code": "US",
"telephone_number": "304-388-1800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1220 Lee St E",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "WV",
"postal_code": "253011863",
"country_code": "US",
"telephone_number": "304-388-1800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDREATTA",
"first_name": "BROCK",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-08",
"last_updated": "2025-10-23",
"certification_date": "2025-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WV",
"license": "35390",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WA",
"license": "MD61616246",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036.124279",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bandreatta33962@direct.luhs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2160 S 1st Ave Ste 3102",
"city": "Maywood",
"state": "IL",
"country_code": "US",
"postal_code": "601533328",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.