Individual provider Active NPI

Kenji Muro, M.D.

  • Neurological Surgery Physician
  • Chicago, IL
National Provider Identifier
1700807591
Registry record updated Dec 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
036-114552 Issued in IL
Practice address
3000 N. Halsted St.
Suite 703
Chicago, IL 60657
Phone
(773) 296-6666
Fax
(773) 296-9999
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 036-114552 IL Primary

Addresses

Primary practice location

3000 N. Halsted St.
Suite 703
Chicago, IL 60657

Mailing address

3000 N. Halsted St.
Suite 703
Chicago, IL 60657
Phone (773) 296-6666

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kmuro205897@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20060815000059 IL Practitioner - NeurosurgeryPractitioner - Medical Oncology 5395748271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurosurgeryAlso: Medical Oncology
Education
Johns Hopkins University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

3000 N Halsted St
Suite 509
Chicago, IL 60657-5194
Phone (773) 296-5090

Hospital & facility affiliations

  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-114552ILMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jan 1, 2014 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 1, 2014 Accepting new patients
Chicago Gastro LLC Past Accepting new patients

Locations

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

3000 N Halsted St
Ste 703
Chicago, IL 60657
Phone (773) 296-6666

29373 Network Pl
Chicago, IL 60673

3000 N Halsted St
Ste 625
Chicago, IL 60657
Phone (773) 296-3450

3000 N Halsted St
Ste 509
Chicago, IL 60657
Phone (773) 296-3390

1301 E 47th St
Chicago, IL 60653
Phone (773) 493-8212

75 Remittance Dr
Dept 6994
Chicago, IL 60675

75 Remittance Dr
Chicago, IL 60675

Interoperability endpoints

  • Direct secure messaging: kmuro205897@direct.myadvocateaurora.org

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 2

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640908800000",
    "number": "1700807591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N. HALSTED ST.",
            "address_2": "SUITE 703",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-296-6666",
            "fax_number": "773-296-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N. HALSTED ST.",
            "address_2": "SUITE 703",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-296-6666",
            "fax_number": "773-296-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURO",
        "first_name": "KENJI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-12-31",
        "certification_date": "2021-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036-114552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmuro205897@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3000 N. Halsted St.",
            "address_2": "Suite 703",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60657",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3000 N. Halsted St.",
            "address_2": "Suite 703",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.