Individual provider Active NPI

Fernando Andres Traslavina, MD

  • Family Medicine Physician
  • Berwyn, IL
National Provider Identifier
1821615030
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.163426 Issued in IL
Practice address
6326 Cermak Rd
Berwyn, IL 60402-2304
Phone
(708) 303-9234
Fax
(773) 729-2074
NPI assigned
Jul 3, 2020
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.163426 IL Primary

Addresses

Primary practice location

6326 Cermak Rd
Berwyn, IL 60402-2304

Mailing address

6326 Cermak Rd
Berwyn, IL 60402-2304
Phone (708) 303-9234

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
I20230615002990 IL Practitioner - Family Practice 4385002856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PMR Illinois Holding LLCGroup PAC ID 2062804909, 10 clinicians

Practice addresses (Care Compare)

6326 Cermak Rd
Berwyn, IL 60402-2304
Phone (708) 303-9234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.163426ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Illinois Holding, LLC CurrentSince Jul 1, 2023 Accepting new patients
Jencare Neighborhood Medical Center Berwyn, LLC CurrentSince Jun 18, 2023 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

6326 Cermak Rd
Berwyn, IL 60402
Phone (708) 303-9234

2734 W 87th St
Chicago, IL 60652
Phone (773) 918-4700

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.

Hospital & facility affiliations 1

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": "1593734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1821615030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6326 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022304",
            "telephone_number": "708-303-9234",
            "fax_number": "773-729-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6326 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022304",
            "telephone_number": "708-303-9234",
            "fax_number": "773-729-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRASLAVINA",
        "first_name": "FERNANDO",
        "middle_name": "ANDRES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-03",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.163426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.