Rada Ivanov, M.D.

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

01085124A Issued in IN

Practice address

5600 W Addison St
Suite 304
Chicago, IL 60634-4401

Phone

(773) 481-1570

Fax

(773) 481-0547

NPI assigned

Jul 7, 2005

Last updated

Oct 31, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL, GU, VI3 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 3

Specialty

Critical Care (Intensivists)

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Governor Juan F Luis Hospital and Medical CenterGroup PAC ID 1153233804, 41 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.22 of 100Reported as group

Quality

78.84

Improvement activities

40

Cost

61.61

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Governor Juan F. Luis Hospital & Medical Center

  • General Acute Care Hospital
  • Christiansted, St. Croix, VI
  • NPI 1972503647
  Medicare reassignment Care Compare group NPD
• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment NPD
• Guam Healthcare Development Incorporated

  dba GRMC Specialty Care Center

  • Clinic/Center
  • Dededo, GU
  • NPI 1326447939
  Medicare reassignment NPD
• Midwest Pulmonary and Sleep

  • Pulmonary Disease Physician
  • Chicago, IL
  • NPI 1811182363
  Authorized official Same address or phone
• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1164477725

  Critical Care Medicine

  NPD
• Decatur Memorial Hospital

  dba Professional Fees

  • Multi-Specialty Clinic/Center
  • Decatur, IL
  • NPI 1477276301
  NPD
• The Board of Trustees of the University of Illinois

  dba Occupational Health Service Institute (OHSI)

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1609094739

  Critical Care Medicine

  NPD
• Governor Juan F. Luis Hospital & Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • St Croix, VI
  • NPI 1740238534
  NPD
• Dhanalakshmi P. Ganesan M.D.S.C

  • Internal Medicine Physician
  • River Forest, IL
  • NPI 1144382201
  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1790782613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 W ADDISON ST",
            "address_2": "SUITE 304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344401",
            "telephone_number": "773-481-1570",
            "fax_number": "773-481-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 W ADDISON ST",
            "address_2": "SUITE 304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344401",
            "telephone_number": "773-481-1570",
            "fax_number": "773-481-0547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11109 Parkview Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451701",
            "country_code": "US",
            "telephone_number": "260-266-2020",
            "fax_number": "260-458-5355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 N Edward St",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625264192",
            "country_code": "US",
            "telephone_number": "217-876-4200",
            "fax_number": "217-876-4209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "302 W Hay St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625264167",
            "country_code": "US",
            "telephone_number": "217-876-4200",
            "fax_number": "217-876-4209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVANOV",
        "first_name": "RADA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036089071",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01085124A",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036089071",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GU",
            "license": "M-2341",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089071",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ECFMG",
            "identifier": "04645032",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jelena Ivanisevic
• Daniel A Ivankovich, M.D.
• Karla K Ivankovich, PHD, LCPC, NCC, BCPC
• Olga Ivankovich
• Atanas Ivanov, FNP
• Diyana Ivanova, OD
• Euginia Ivanova, MSW, CADC
• Gergana Ivanova
• Maria Ivanova, APRN
• Aleksandra Ivanovic, MD

• Critical Care Medicine (Internal Medicine) Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Critical Care Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.