Active NPI
James Marlin McCluskey III, MD
- Pediatrics Physician
- Chicago, IL
National Provider Identifier
1770109126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036.168457
- Practice address
- 251 E Huron St
Chicago, IL 60611-2908 - Phone
- (312) 926-2000
- NPI assigned
- Jun 22, 2020
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 036.168457 | IL | |
| Pediatric Infectious Diseases Physician | 2080P0208X | 036.168457 | IL | |
| Internal Medicine Physician | 207R00000X | 036.168457 | IL | |
| Pediatrics Physician | 208000000X | 036.168457 | IL | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
251 E Huron St
Chicago, IL 60611-2908
Mailing address
221 East Chicago Avenue
7TH Floor
Chicago, IL 60611-2991
Other practice location 1
983040 Nebraska Medical Ctr
Omaha, NE 68198-3040
Phone (402) 559-8501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210125000818 | NE | Order and Referring Only - Internal Medicine | 6103230693 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8789 | NE | MD | Pharmacist |
| 036.168457 | IL | MD | Pediatric Infectious Diseases Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1770109126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 EAST CHICAGO AVENUE",
"address_2": "7TH FLOOR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "251 E HURON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112908",
"telephone_number": "312-926-2000"
}
],
"practiceLocations": [
{
"address_1": "983040 Nebraska Medical Ctr",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681983040",
"country_code": "US",
"telephone_number": "402-559-8501",
"fax_number": "402-559-9385",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCLUSKEY",
"first_name": "JAMES",
"middle_name": "MARLIN",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-22",
"last_updated": "2024-06-24",
"certification_date": "2024-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "IL",
"license": "036.168457",
"primary": false
},
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "IL",
"license": "036.168457",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036.168457",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036.168457",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"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 Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.