NPIMap

Individual provider Active NPI

Yongsun Ra-Hurka, MD

  • Internal Medicine Physician
  • Maywood, IL
National Provider Identifier
1821062944
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36106096 Issued in IL
Practice address
2160 S First Ave
(321 N Lagrange Rd., Lagrange, Il. 60526)
Maywood, IL 60153
Phone
(708) 485-1020
Fax
(708) 485-1173
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36106096 IL Primary

Addresses

Primary practice location

2160 S First Ave
(321 N Lagrange Rd., Lagrange, Il. 60526)
Maywood, IL 60153

Mailing address

2160 S First Ave
(321 N Lagrange Rd., Lagrange, Il. 60526)
Maywood, IL 60153
Phone (708) 485-1020

Other identifiers 1

IdentifierTypeStateIssuer
36106096MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address yrahurka25418@direct.luhs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100116000077 IL Practitioner - Internal Medicine 6305988114 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians
Loyola Medical Group LLCGroup PAC ID 6305109547, 124 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

3231 Euclid Ave
Suite 202
Berwyn, IL 60402-3472
Phone (708) 783-2700

Hospital & facility affiliations

  • Loyola Medicine Home Care Home health agency, Oak Brook, IL, CCN 147257
  • Residential Home Health Home health agency, Lisle, IL, CCN 147568
  • Loyola University Medical Center Hospital, Maywood, IL, CCN 140276
  • Loyola Gottlieb Memorial Hospital Hospital, Melrose Park, IL, CCN 140008
  • Uchicago Medicine Adventhealth Hinsdale Hospital, Hinsdale, IL, CCN 140122
  • Macneal Hospital Hospital, Berwyn, IL, CCN 140054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36106096ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince May 1, 2002 Accepting new patients
Loyola University Medical Center CurrentSince May 1, 2002 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Loyola Medical Group LLC CurrentSince Jul 21, 2022 Accepting new patients
Loyola University Physician Foundation Past Accepting new patients
Gottlieb Community Health Services Corporation Past Accepting new patients

Locations

3231 Euclid Ave
Ste 202
Berwyn, IL 60402
Phone (708) 783-2700

3231 Euclid Ave
Ste 407
Berwyn, IL 60402
Phone (708) 783-7430

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

47 6th Ave
Lagrange Hlds, IL 60525
Phone (708) 354-4900

2160 S 1st Ave
#321N
Maywood, IL 60153
Phone (708) 485-1020

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

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 8

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1821062944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "address_2": "(321 N LAGRANGE RD., LAGRANGE, IL. 60526)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-485-1020",
            "fax_number": "708-485-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "address_2": "(321 N LAGRANGE RD., LAGRANGE, IL. 60526)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-485-1020",
            "fax_number": "708-485-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RA-HURKA",
        "first_name": "YONGSUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36106096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36106096",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "yrahurka25418@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S First Ave",
            "address_2": "(321 N LaGrange Rd., LaGrange, IL. 60526)",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.