Active NPI
Michael Gottlieb, M.D.
- Emergency Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036139544
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
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
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
- Northshore University Healthsystem - Evanston Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Current | Accepting new patients | |
| Rush University Medical Center | Current | Accepting new patients | |
| Cook County | Current | Accepting new patients | |
| Cook County | Current | Accepting new patients | |
| Rush University Medical Group | Emergency Medicine | Current | Accepting new patients |
| Cook County | Emergency Medicine | Current | Accepting new patients |
| Rush Oak Park ER Physicians Group | Current | 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
- mgottlieb16638@direct.rush.rush-health.com
- 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.
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1093819542
Emergency Medicine
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1588612832
-
- Emergency Medicine Physician
- Evanston, IL
- NPI 1497701882
-
- Emergency Medical Services (Emergency Medicine) Physician
- Oak Park, IL
- NPI 1447260880
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1821385170
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1831219450
-
- Anesthesiology Physician
- Evanston, IL
- NPI 1265695944
-
- Diagnostic Radiology Physician
- Chicago, IL
- NPI 1184269425
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Evanston, IL
- NPI 1184670549
-
- Children's Hospital
- Chicago, IL
- NPI 1801908728
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1932213600
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.