Individual provider Active NPI

Paul D Belich, MD

  • Orthopaedic Surgery Physician
  • Maywood, IL
National Provider Identifier
1821067588
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036049020 Issued in IL
Practice address
2160 S 1St Ave BLDG 105-1700
Maywood, IL 60153-3328
Phone
(708) 216-5825
Fax
(708) 216-5858
NPI assigned
Mar 15, 2006
Last updated
Jul 23, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036049020 IL Primary

Addresses

Primary practice location

2160 S 1St Ave BLDG 105-1700
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave BLDG 105-1700
Maywood, IL 60153-3328
Phone (708) 216-5825

Other identifiers 3

IdentifierTypeStateIssuer
21606716OtherILBLUE CROSS BLUE SHIELD
036049020MedicaidIL
49127601OtherILUNITED HEALTHCARE

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
I20060103000273 IL Practitioner - Orthopedic SurgeryPractitioner - Physical Medicine and Rehabilitation 2264450758

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Chicago Orthopaedics and Sports Medicine SC Orthopaedic Surgery Past Accepting new patients

Locations

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

2160 S 1st Ave
Bldg 101
Maywood, IL 60153
Phone (708) 216-8785

2160 S 1st Ave
Bldg 1051700
Maywood, IL 60153
Phone (708) 216-5825

Interoperability endpoints

  • Direct secure messaging: pbelich16404@direct.luhs.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1821067588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE BLDG 105-1700",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-5825",
            "fax_number": "708-216-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE BLDG 105-1700",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-5825",
            "fax_number": "708-216-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELICH",
        "first_name": "PAUL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036049020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "21606716",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036049020",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "49127601",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.