Steven Vsevolod Trakhtman, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

675 W North Ave
Suite 606
Melrose Park, IL 60160-1634

Phone

(708) 681-7877

Fax

(800) 801-6284

NPI assigned

Aug 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Lake Shore Adult & Geriatric Medicine, LTD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1326056276
  Medicare reassignment

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831100361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8936 NILES CENTER RD UNIT D",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761847",
            "telephone_number": "847-606-7988",
            "fax_number": "800-801-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "SUITE 606",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-681-7877",
            "fax_number": "800-801-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAKHTMAN",
        "first_name": "STEVEN",
        "middle_name": "VSEVOLOD",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracey Elena Tillis
• Darold S Tolefree, MSW
• Total Foot and Ankle PLLC
• Andrew Robert Townsend, CT
• Tracy Campbell MD LLC
• Alejandra Trimino, LSW
• Yuridia Trujillo, BSW
• Nicole Emily Trytko, DMD
• Latoya D Tucker
• Payton Turner-Hewlett, BA, MHP

• Medical Physician Assistant in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.