Individual provider Active NPI

Mary F. Burke, M.D.

  • Gynecology Physician
  • Olympia Fields, IL
National Provider Identifier
1750345534
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
036-076479 Issued in IL
Practice address
3700 W 203Rd St
Ste 201
Olympia Fields, IL 60461-1180
Phone
(708) 679-2880
Fax
(708) 503-3295
NPI assigned
Apr 17, 2006
Last updated
Mar 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036076479 IL
Gynecology Physician 207VG0400X 036-076479 IL Primary

Addresses

Primary practice location

3700 W 203Rd St
Ste 201
Olympia Fields, IL 60461-1180

Mailing address

1040 Sierra Dr
Suite 400
Greenwood, IN 46143-7240
Phone (317) 528-4800

Other identifiers 1

IdentifierTypeStateIssuer
036076479MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mburke4634@Direct.FranciscanAlliance.org Direct

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 Medicine

State licenses

LicenseStateTypeSpecialty
036076479ILMDObstetrics & Gynecology Physician
036-076479ILMDGynecology Physician

Interoperability endpoints

  • Direct secure messaging: mburke4634@direct.franciscanalliance.org

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1750345534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SIERRA DR",
            "address_2": "SUITE 400",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437240",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W 203RD ST",
            "address_2": "STE 201",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611180",
            "telephone_number": "708-679-2880",
            "fax_number": "708-503-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "MARY",
        "middle_name": "F.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036076479",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "036-076479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036076479",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mburke4634@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3700 W 203rd St",
            "address_2": "Ste 201",
            "city": "Olympia Fields",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604611180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.