Individual provider Active NPI

Lyudmyla Polupan, M.D.

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1790091809
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036126431 Issued in IL
Practice address
1901 W Harrison St
Chicago, IL 60612-3714
Phone
(312) 864-6000
NPI assigned
Aug 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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 036126431 IL Primary

Addresses

Primary practice location

1901 W Harrison St
Chicago, IL 60612-3714

Mailing address

109 E Fox Hill Dr
Buffalo Grove, IL 60089-1519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120619000506 IL Practitioner - AnesthesiologyPractitioner - Interventional Pain ManagementPractitioner - Pain Management 6507020740 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management, Pain Management
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

2739 W Foster Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

5140 N California
Suite G600
Chicago, IL 60625-3645
Phone (773) 989-3803

5140 N California Ave
Chicago, IL 60625-3645

5145 N California
Hosps Suite 331
Chicago, IL 60625-3661
Phone (847) 570-2280

5145 N California Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036126431ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Anesthesiology CurrentSince Oct 13, 2023 Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Jun 1, 2016 Accepting new patients
Swedish Covenant Management Services, Inc. CurrentSince Jun 1, 2016 Accepting new patients
Windy City Anesthesia PC Anesthesiology CurrentSince Jul 1, 2016 Accepting new patients
Windy City Anesthesia PC CurrentSince Jul 1, 2016 Accepting new patients
Endeavor Health Medical Group Anesthesiology Current Accepting new patients

Locations

1256 Waterford Dr
Ste 130
Aurora, IL 60504
Phone (630) 820-2727

355 E Grand Ave
Chicago, IL 60611
Phone (312) 587-3432

1338 E 47th St
Chicago, IL 60653
Phone (773) 324-3338

9532 Eagle Way
Chicago, IL 60678

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

5145 N California Ave
Chicago, IL 60625
Phone (773) 989-3800

900 Rand Rd
Des Plaines, IL 60016
Phone (847) 324-9676

1614 N Harlem Ave
Elmwood Park, IL 60707
Phone (708) 452-5000

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

21120 Washington Pkwy
Frankfort, IL 60423
Phone (815) 469-9750

10401 S Roberts Rd
Ste 2
Palos Hills, IL 60465
Phone (708) 430-1600

Organizations & group practices 6

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 1

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": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1790091809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E FOX HILL DR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLUPAN",
        "first_name": "LYUDMYLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036126431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.