Mario Tavakoli, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036173752 Issued in IL

Practice address

1740 W Taylor St
Chicago, IL 60612-7232

Phone

(312) 996-2933

NPI assigned

Mar 31, 2022

Last updated

Apr 29, 2025By the provider in NPPES

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

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

Internal Medicine

Education

Touro Un Col of Osteopathic Medicine, New York, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mtavakoli135917@uihealth.direct-ci.com

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.

• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment Care Compare group NPD
• The Board of Trustees of the University of Illinois

  dba Occupational Health Service Institute (OHSI)

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  • Neurology Physician
  • Chicago, IL
  • NPI 1982824660
  NPD

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

• The Board of Trustees of the University of Illinois

  dba University of Illinois Hospital and Clinics

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1861431751
  Care Compare affiliation

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1710627195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 SOUTH WOOD STREET",
            "address_2": "SUITE 100, MC 675",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-996-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "312-996-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAKOLI",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036173752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE NUMBER",
            "identifier": "036173752",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanna Taubeneck, LPC, R-DMT
• Alexis Lybrook Taubert, PH.D.
• Christina Marie Taufen, D.O.
• Michelle Taufmann, LSW
• Jeffery Edmund Taugner, D.D.S.
• Shedeh Tavakoli, PH.D.
• Shayan Tavana, PHARMD
• Ana Marleny Tavarez, APN
• Danielle Renae Tavasti
• Dustin Gayle Tavenner, D.C.

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.