Active NPI
Justin Eugene Mitchell, D.O.
- Gastroenterology Physician
- Maywood, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 036.130251
- Practice address
- 2160 S 1St Ave
Maywood, IL 60153-3328 - Phone
- (708) 216-9000
- NPI assigned
- Apr 29, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 036.130251 | IL | Primary |
Addresses
Primary practice location
2160 S 1St Ave
Maywood, IL 60153-3328
Mailing address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1620 W Harrison St
Chicago, IL 60612-3801
1625 N Harlem Ave
Chicago, IL 60707-4303
1653 W Congress Pkwy
Chicago, IL 60612-3833
1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875
1725 W Harrison St
Chicago, IL 60612-3841
1725 W Harrison St
Chicago, IL 60612-3861
1725 W Harrison St
Suite 450
Chicago, IL 60612-4828
Phone (312) 563-4238
520 S Maple Ave
Oak Park, IL 60304-1022
Phone (708) 660-2240
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 34 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.130251 | IL | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rush University Medical Group | Current | Accepting new patients | |
| Rush University Medical Center | Past | Accepting new patients |
Locations
2600 S Michigan Ave
Ste 408
Chicago, IL 60616
Phone (312) 808-0900
1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875
1725 W Harrison St
Ste 352
Chicago, IL 60612
Phone (312) 563-3447
1625 N Harlem Ave
Chicago, IL 60707
Phone (312) 256-8583
1725 W Harrison St
Ste 161
Chicago, IL 60612
Phone (312) 942-4252
75 Remittance Dr
Dept 1611
Chicago, IL 60675
Interoperability endpoints
- jmitchell129483@direct.rush.rush-health.com
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.
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1093819542
-
- Cardiovascular Disease Physician
- Chicago, IL
- NPI 1578584140
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oak Park, IL
- NPI 1558391706
-
- Children's Hospital
- Chicago, IL
- NPI 1801908728
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1932213600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474329600000",
"number": "1689818098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "JUSTIN",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-29",
"last_updated": "2016-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IL",
"license": "036.130251",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Sep 20, 2016; 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.