Individual provider Active NPI

John M. Bailitz, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1710988654
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036105881 Issued in IL
Practice address
211 E. Ontario St.
Northwestern Medicine
Chicago, IL 60611
Phone
(312) 694-7000
Fax
(312) 926-6274
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036105881 IL Primary

Addresses

Primary practice location

211 E. Ontario St.
Northwestern Medicine
Chicago, IL 60611

Mailing address

680 N Lake Shore Dr
Chicago, IL 60611-4546
Phone (312) 695-9797

Other identifiers 1

IdentifierTypeStateIssuer
036105881OtherILILLINOIS LICENSE

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
I20040211000516 IL Practitioner - Emergency Medicine 0749174688 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Northwestern University Feinberg Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

4445 W Irving Park Rd
Chicago, IL 60641-2808

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

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
036105881ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2017 Accepting new patients
Cook County CurrentSince Nov 4, 2010 Accepting new patients
Cook County Current Accepting new patients
Cook County Emergency Medicine CurrentSince Nov 4, 2010 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2017 Accepting new patients
Elmhust Emergency Medical Services, LTD Emergency Medicine Past Accepting new patients
Central Dupage Physician Group Past Accepting new patients
Elmhurst Memorial Hospital Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

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

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

680 N Lake Shore Dr
Chicago, IL 60611
Phone (312) 503-6000

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 8

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 1

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1710988654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-695-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E. ONTARIO ST.",
            "address_2": "NORTHWESTERN MEDICINE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-694-7000",
            "fax_number": "312-926-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILITZ",
        "first_name": "JOHN",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036105881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE",
            "identifier": "036105881",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.