Individual provider Active NPI

Brian Saliba, MD

  • Obstetrics & Gynecology Physician
  • Park City, IL
National Provider Identifier
1649711995
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036.155419 Issued in IL
Practice address
351 Greenleaf St Ste a
Park City, IL 60085-5701
Phone
(847) 244-4110
NPI assigned
Mar 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 125.070234 IL
Obstetrics & Gynecology Physician 207V00000X 036.155419 IL Primary

Addresses

Primary practice location

351 Greenleaf St Ste a
Park City, IL 60085-5701

Mailing address

351 Greenleaf St Ste a
Park City, IL 60085-5701
Phone (847) 244-4110

Other practice location 1

1875 Dempster St
Suite 330
Park Ridge, IL 60068-1186
Phone (847) 655-8530

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
I20210630003443 IL Practitioner - Obstetrics/Gynecology 0941572572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William E Woods MD SCGroup PAC ID 5294759692, 2 clinicians

Practice addresses (Care Compare)

351 S Greenleaf Ave
Suite a
Park City, IL 60085-5701
Phone (847) 244-4110

Hospital & facility affiliations

  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.155419ILMDObstetrics & Gynecology Physician
125.070234ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William E. Woods, MDSC Obstetrics & Gynecology CurrentSince Aug 2, 2021 Accepting new patients
Central Dupage Physician Group PastSince Jun 27, 2021 Accepting new patients
Mobile Anesthesiologists Chicago LLC PastSince Jun 27, 2021 Accepting new patients

Organizations & group practices 3

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": "1489881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1649711995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 GREENLEAF ST STE A",
            "city": "PARK CITY",
            "state": "IL",
            "postal_code": "600855701",
            "telephone_number": "847-244-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 GREENLEAF ST STE A",
            "city": "PARK CITY",
            "state": "IL",
            "postal_code": "600855701",
            "telephone_number": "847-244-4110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1875 Dempster St",
            "address_2": "Suite 330",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681186",
            "country_code": "US",
            "telephone_number": "847-655-8530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALIBA",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-19",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125.070234",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036.155419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, IL

Sources for this page

Verify at the official NPI Registry.