Individual provider Active NPI

Michael T Conran, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1720434608
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085005937 Issued in IL
Practice address
676 N Saint Clair St Ste 2140
Chicago, IL 60611-3143
Phone
(312) 472-1234
Fax
(312) 695-3644
NPI assigned
May 10, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085005937 IL Primary

Addresses

Primary practice location

676 N Saint Clair St Ste 2140
Chicago, IL 60611-3143

Mailing address

676 N Saint Clair St Ste 2140
Chicago, IL 60611-3143
Phone (312) 472-1234

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160930000231 IL Practitioner - Physician Assistant 8921395203 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085005937ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Oct 30, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 30, 2023 Accepting new patients
Renpro Indiana LLC Current Accepting new patients
Rush University Medical Group CurrentSince May 11, 2020 Accepting new patients
Central Dupage Physician Group Past Accepting new patients
Pulmonary Consultants, SC PastSince Sep 1, 2004 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

676 N Saint Clair St
Ste 2140
Chicago, IL 60611
Phone (312) 664-5400

1725 W Harrison St
Ste 54
Chicago, IL 60612
Phone (312) 942-5871

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

4400 W 95th St
Ste 205
Oak Lawn, IL 60453
Phone (708) 346-4040

Interoperability endpoints

  • Direct secure messaging: mconran163921@direct.rush.rush-health.com

Organizations & group practices 7

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": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1720434608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 2140",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113143",
            "telephone_number": "312-472-1234",
            "fax_number": "312-695-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 2140",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113143",
            "telephone_number": "312-472-1234",
            "fax_number": "312-695-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAN",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-10",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.