Active NPI
Ellen Marie Markus, M.D.,
- Psychiatry Physician
- Chicago, IL
National Provider Identifier
1730390048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036-99512
- Practice address
- 676 N Saint Clair St
Suite#1785
Chicago, IL 60611 - Phone
- (312) 867-0331
- NPI assigned
- May 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036-99512 | IL | Primary |
Addresses
Primary practice location
676 N Saint Clair St
Suite#1785
Chicago, IL 60611
Mailing address
676 N Saint Clair St
Suite#1785
Chicago, IL 60611-2927
Phone (312) 867-0331
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20-3377504 | Other | IL | FEIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 11, 2021 through Jun 11, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-99512 | IL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526515200000",
"number": "1730390048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "676 N SAINT CLAIR ST",
"address_2": "SUITE#1785",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112927",
"telephone_number": "312-867-0331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "676 N SAINT CLAIR ST",
"address_2": "SUITE#1785",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60611",
"telephone_number": "312-867-0331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKUS",
"first_name": "ELLEN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "M.D.,",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-25",
"last_updated": "2018-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036-99512",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEIN",
"identifier": "20-3377504",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.