Individual provider Active NPI

Oleg V. Korolev, M.D.

  • Anesthesiology Physician
  • Oak Park, IL
National Provider Identifier
1750383535
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036103607 Issued in IL
Practice address
3 Erie CT
Westlake Hospital / Anesthesia Department
Oak Park, IL 60302-2519
Phone
(708) 524-9130
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036103607 IL Primary

Addresses

Primary practice location

3 Erie CT
Westlake Hospital / Anesthesia Department
Oak Park, IL 60302-2519

Mailing address

68 S. Service Rd.
Ste 350
Melville, NY 11747-2358
Phone (516) 945-3351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041123000389 IL Practitioner - Anesthesiology 4183689771 Reassigns benefits to 1 organization
I20181109002828 IN Practitioner - Anesthesiology 4183689771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1982
Medicare assignment
May accept Medicare assignment
Group practices
Clinical Colleagues IncGroup PAC ID 8729011333, 170 clinicians

Practice addresses (Care Compare)

1260 E State Rd
Suite 205
Columbia City, IN 46725-9492
Phone (260) 248-9301

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Colleagues Inc Anesthesiology CurrentSince Dec 10, 2018 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC Anesthesiology CurrentSince Jul 11, 2012 Accepting new patients
Macneal Physicians Group LLC Past Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1225 W Lake St
Melrose Park, IL 60160
Phone (708) 681-3000

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

1260 E State Road 205
Columbia City, IN 46725
Phone (260) 248-9000

1721 Magnavox Way
Fort Wayne, IN 46804
Phone (260) 250-0001

207 N Townline Rd
Lagrange, IN 46761
Phone (260) 266-5300

9 Northeastern Blvd
Ste 400
Salem, NH 03079

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

Organizations & group practices 3

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 3

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1750383535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 S. SERVICE RD.",
            "address_2": "STE 350",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472358",
            "telephone_number": "516-945-3351",
            "fax_number": "516-945-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ERIE CT",
            "address_2": "WESTLAKE HOSPITAL / ANESTHESIA DEPARTMENT",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022519",
            "telephone_number": "708-524-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROLEV",
        "first_name": "OLEG",
        "middle_name": "V.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036103607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.