NPIMap

Individual provider Active NPI

Eric Michael Liotta, M.D.

  • Neurocritical Care Physician
  • Chicago, IL
National Provider Identifier
1700048139
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
License
036.127541 Issued in IL
Practice address
680 N Lake Shore Dr
Suite 1000
Chicago, IL 60611-4546
Phone
(312) 908-5633
Fax
(312) 908-5073
NPI assigned
Jun 26, 2008
Last updated
Oct 6, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036.127541 IL
Neurocritical Care Physician 2084A2900X 036.127541 IL Primary

Addresses

Primary practice location

680 N Lake Shore Dr
Suite 1000
Chicago, IL 60611-4546

Mailing address

710 N Lake Shore Dr
Abbott Hall 1116
Chicago, IL 60611-3006
Phone (312) 908-5633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140730002640 IL Practitioner - NeurologyPractitioner - Critical Care (Intensivists) 2567688393 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Critical Care (Intensivists)
Education
Ohio State University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

259 E Erie St
Suite 1900
Chicago, IL 60611-3246
Phone (312) 695-7950

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.127541ILMDNeurocritical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Mar 1, 2020 Accepting new patients
Swedish Covenant Management Services, Inc. CurrentSince Oct 25, 2018 Accepting new patients
Swedish Covenant Management Services, Inc. Neurology Current Accepting new patients
Central Dupage Physician Group CurrentSince Mar 1, 2020 Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Oct 25, 2018 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1700048139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N LAKE SHORE DR",
            "address_2": "ABBOTT HALL 1116",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113006",
            "telephone_number": "312-908-5633",
            "fax_number": "312-908-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-908-5633",
            "fax_number": "312-908-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIOTTA",
        "first_name": "ERIC",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036.127541",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "IL",
            "license": "036.127541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.