Keith David Bowersox, M.D, PHD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

036078229 Issued in IL

Practice address

800 Biesterfield Rd
Suite 4005
Elk Grove Village, IL 60007-3361

Phone

(847) 593-4116

Fax

(847) 593-4135

NPI assigned

Jun 1, 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 1

Electronic endpoints 1

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

Specialty

Cardiac SurgeryAlso: Thoracic Surgery

Education

Indiana University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiothoracic and Vascular Surgical Associates S CGroup PAC ID 7214916402, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258
• Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030
• Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
• Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291
• St Alexius Medical Center Hospital, Hoffman Estates, IL, CCN 140290

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbowersox140732@direct.rush.rush-health.com
• Direct secure messaging: kbowersox236548@direct.myadvocateaurora.org

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.

• Cardiothoracic & Vascular Surgical Associates S C

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Oak Lawn, IL
  • NPI 1780679407
  Medicare reassignment Care Compare group NPD
• City of Hope Medical Group of Illinois PLLC

  • Specialist
  • Zion, IL
  • NPI 1548258072
  Medicare reassignment NPD
• Cardiac Surgery Associates SC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Downers Grove, IL
  • NPI 1043269160
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Condell Medical Center

  • Mobile Mammography Clinic/Center
  • Gurnee, IL
  • NPI 1023262441

  Hospital

  Care Compare affiliation
• Advocate Condell Medical Center

  • General Acute Care Hospital
  • Libertyville, IL
  • NPI 1124272547
  Care Compare affiliation
• Advocate Condell Medical Center

  • Mobile Mammography Clinic/Center
  • Grayslake, IL
  • NPI 1770737199

  Hospital

  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Barrington, IL
  • NPI 1447368071
  Care Compare affiliation
• Advocate Sherman Hospital

  • General Acute Care Hospital
  • Elgin, IL
  • NPI 1629026364
  Care Compare affiliation
• Alexian Brothers Medical Center

  • General Acute Care Hospital
  • Elk Grove Village, IL
  • NPI 1265577191
  Care Compare affiliation
• Sherman Hospital

  • Skilled Nursing Facility
  • Elgin, IL
  • NPI 1275584302

  Hospital

  Care Compare affiliation
• St. Alexius Medical Center

  • General Acute Care Hospital
  • Hoffman Estates, IL
  • NPI 1376644385
  Care Compare affiliation

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1669474870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST STE 308",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532660",
            "telephone_number": "708-346-4040",
            "fax_number": "708-346-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "SUITE 4005",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-593-4116",
            "fax_number": "847-593-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERSOX",
        "first_name": "KEITH",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036078229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036078229",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbowersox236548@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "800 Biesterfield Rd",
            "address_2": "SUITE 4005",
            "city": "Elk Grove Village",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600073361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Traci Allison Bookler
• Amy Bordwell
• Marilyn Borkgren, APN, MS
• Anne Rogers Bosslet, OTR/L
• George K Bovis, MD
• Amanda Bozich, D.P.M.
• Caryn Kathleen Brauweiler, LCSW
• Terry Brennan
• Denise Brents, APN
• Steven Brey, M.D.

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.

Verify at the official NPI Registry.