Active NPI
Elizabeth Rose Mueller
- Urology Physician
- Maywood, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 36104051
- Practice address
- 2160 S First Ave
Maywood, IL 60153 - Phone
- (708) 216-5102
- Fax
- (708) 216-1699
- NPI assigned
- Feb 27, 2006
- Last updated
- Apr 12, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 36104051 | IL | Primary |
Addresses
Primary practice location
2160 S First Ave
Maywood, IL 60153
Mailing address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-5102
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36104051 | Medicaid | IL | |
| K17440 | Other | IL | MEDICARE |
Other names 1
- Elizabeth Rose Mueller
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | emueller24581@direct.luhs.org | Other |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36104051 | IL | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Little Company of Mary Affiliated Services Inc | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Little Company of Mary Affiliated Services Inc | Current | Accepting new patients | |
| Osf Healthcare System | Past | Accepting new patients |
Locations
2800 W 87th St
Chicago, IL 60652
Phone (312) 423-4200
2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400
12450 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 448-1207
Organizations & group practices 4
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.
-
dba Little Co of Mary Care Station
- Urgent Care Clinic/Center
- Oak Lawn, IL
- NPI 1033162086
-
dba Little Co of Mary Affiliated
- Internal Medicine Physician
- Evergreen Park, IL
- NPI 1588617260
-
dba Foster G. McGaw Hospital
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
dba OSF Saint Katharine Medical Center
- General Acute Care Hospital
- Dixon, IL
- NPI 1508683590
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681257600000",
"number": "1871569186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-5102",
"fax_number": "708-216-1699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S FIRST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "60153",
"telephone_number": "708-216-5102",
"fax_number": "708-216-1699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUELLER",
"first_name": "ELIZABETH",
"middle_name": "ROSE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-27",
"last_updated": "2023-04-12",
"certification_date": "2023-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IL",
"license": "36104051",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36104051",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "K17440",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "emueller24581@direct.luhs.org",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "2160 S First Ave",
"city": "Maywood",
"state": "IL",
"country_code": "US",
"postal_code": "60153",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "MUELLER",
"middle_name": "ROSE",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.