Individual provider Active NPI

Michael Gottlieb, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1821355082
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036139544 Issued in IL
Practice address
1900 W Polk St
Dept of Emergency Medicine - 10TH Floor
Chicago, IL 60612-3723
Phone
(312) 864-0062
NPI assigned
Apr 12, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036139544 IL Primary

Addresses

Primary practice location

1900 W Polk St
Dept of Emergency Medicine - 10TH Floor
Chicago, IL 60612-3723

Mailing address

1750 West Harrison Street
Suite 108 Kellogg
Chicago, IL 60612

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgottlieb2@direct.ccprovider.org Direct Cook County

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
I20160705002192 IL Practitioner - Emergency Medicine 0648584482 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rush Medical College of Rush University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1653 W Congress Pkwy
Chicago, IL 60612-3833

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Sep 11, 2024 Accepting new patients
Rush University Medical Center CurrentSince Oct 1, 2020 Accepting new patients
Cook County CurrentSince Aug 18, 2017 Accepting new patients
Cook County Current Accepting new patients
Rush University Medical Group Emergency Medicine CurrentSince Oct 1, 2020 Accepting new patients
Cook County Emergency Medicine CurrentSince Aug 18, 2017 Accepting new patients
Rush Oak Park ER Physicians Group CurrentSince Dec 1, 2023 Accepting new patients
Endeavor Health Medical Group Emergency Medicine Current Accepting new patients

Locations

1653 W Congress Pkwy
#177
Chicago, IL 60612
Phone (312) 947-0229

75 Remittance Dr
Dept 1620
Chicago, IL 60675

9532 Eagle Way
Chicago, IL 60678

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

1750 W Harrison St
Ste 108
Chicago, IL 60612
Phone (312) 942-7802

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1900 W Polk St
Fl 10
Chicago, IL 60612
Phone (312) 864-0060

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

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

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

Interoperability endpoints

  • Direct secure messaging: mgottlieb16638@direct.rush.rush-health.com
  • Direct secure messaging: mgottlieb2@direct.ccprovider.org

Organizations & group practices 8

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 3

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": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1821355082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 WEST HARRISON STREET",
            "address_2": "SUITE 108 KELLOGG",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W POLK ST",
            "address_2": "DEPT OF EMERGENCY MEDICINE - 10TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036139544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgottlieb2@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.