Active NPI
Michael Anthony Puisis, D.O.
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1730499518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036068255
- Practice address
- 2800 South California
Chicago, IL 60608-5107 - Phone
- (773) 869-3658
- NPI assigned
- Oct 14, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036068255 | IL | Primary |
Addresses
Primary practice location
2800 South California
Chicago, IL 60608-5107
Mailing address
932 Wesley
Evanston, IL 60202
Phone (773) 869-5641
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287014400000",
"number": "1730499518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "932 WESLEY",
"city": "EVANSTON",
"state": "IL",
"postal_code": "60202",
"telephone_number": "773-869-5641",
"fax_number": "773-869-7177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 SOUTH CALIFORNIA",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606085107",
"telephone_number": "773-869-3658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUISIS",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-14",
"last_updated": "2010-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036068255",
"primary": true
}
],
"identifiers": [],
"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 Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.