Active NPI
Andrew Mazulis, M.D.
- Gastroenterology Physician
- Libertyville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 036-135984
- Practice address
- 825 S Milwaukee Ave
Libertyville, IL 60048-3218 - Phone
- (847) 573-2845
- NPI assigned
- Apr 5, 2012
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 1699031583 | IL | |
| Gastroenterology Physician | 207RG0100X | 69801-20 | WI | |
| Gastroenterology Physician | 207RG0100X | 036-135984 | IL | Primary |
Addresses
Primary practice location
825 S Milwaukee Ave
Libertyville, IL 60048-3218
Mailing address
29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900
Other practice location 1
6308 8th Ave # 202
Kenosha, WI 53143-5031
Phone (262) 653-5330
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 69801-20 | Other | WI | LICENSE |
| 1699031583 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | amazulis387463@direct.myadvocateaurora.org | Direct |
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, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
825 S Milwaukee Ave
Libertyville, IL 60048-3218
Phone (847) 362-1393
Hospital & facility affiliations
- Advocate Condell Medical Center
- Advocate Illinois Masonic Medical Center
- Advocate Good Shepherd Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 175 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 201 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1699031583 | IL | MD | Internal Medicine Physician |
| 036-135984 | IL | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| Best Practices Inpatient Care,LTD | Internal Medicine | Current | Accepting new patients |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Internal Medicine | Current | Accepting new patients |
| Best Practices Inpatient Care, LTD. | Internal Medicine | Current | Accepting new patients |
| The Medical College of Wisconsin, Inc. | Internal Medicine | Current | Accepting new patients |
| Advocate Health & Hospitals Corp. | Current | Accepting new patients | |
| Froedtert South, Inc. | Current | Accepting new patients |
Locations
800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150
106 Barrington Commons Ct
Unit 1790
Barrington, IL 60011
Phone (847) 719-2220
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
29373 Network Pl
Chicago, IL 60673
755 S Milwaukee Ave
Ste 225
Libertyville, IL 60048
Phone (847) 573-2845
825 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-1393
450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123
W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060
6308 8th Ave
#202
Kenosha, WI 53143
Phone (262) 653-5330
6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300
W126N7338 Flint Dr
Ste 200
Menomonee Falls, WI 53051
9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451
Interoperability endpoints
- amazulis387463@direct.myadvocateaurora.org
Organizations & group practices 9
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.
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Internal Medicine Physician
- Barrington, IL
- NPI 1619913522
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1750315545
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- Internal Medicine Physician
- Wyoming, MI
- NPI 1417240946
-
- Durable Medical Equipment & Medical Supplies
- Wauwatosa, WI
- NPI 1154947224
-
- Internal Medicine Physician
- Menomonee Falls, WI
- NPI 1568787448
-
- Family Medicine Physician
- Kenosha, WI
- NPI 1558305284
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Libertyville, IL
- NPI 1124272547
-
- Mobile Mammography Clinic/Center
- Grayslake, IL
- NPI 1770737199
Hospital
-
- General Acute Care Hospital
- Barrington, IL
- NPI 1447368071
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1912014564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704412800000",
"number": "1699031583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29373 NETWORK PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606731293",
"telephone_number": "847-390-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 S MILWAUKEE AVE",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600483218",
"telephone_number": "847-573-2845"
}
],
"practiceLocations": [
{
"address_1": "6308 8th Ave # 202",
"address_purpose": "LOCATION",
"city": "Kenosha",
"state": "WI",
"postal_code": "531435031",
"country_code": "US",
"telephone_number": "262-653-5330",
"fax_number": "262-653-5346",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAZULIS",
"first_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-05",
"last_updated": "2024-01-05",
"certification_date": "2024-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "1699031583",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "WI",
"license": "69801-20",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IL",
"license": "036-135984",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "69801-20",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1699031583",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "825 S Milwaukee Ave",
"city": "Libertyville",
"state": "IL",
"country_code": "US",
"postal_code": "600483218",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "amazulis387463@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "825 S Milwaukee Ave",
"city": "Libertyville",
"state": "IL",
"country_code": "US",
"postal_code": "600483218",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Libertyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.