Individual provider Active NPI

Elizabeth Rose Mueller

  • Urology Physician
  • Maywood, IL
National Provider Identifier
1871569186
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
36104051 Issued in IL
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, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
36104051MedicaidIL
K17440OtherILMEDICARE

Other names 1

  • Elizabeth Rose Mueller Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050524000800 IL Practitioner - UrologyPractitioner - Obstetrics/Gynecology 0547202137 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36104051ILMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew 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 CurrentSince Mar 1, 2015 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.

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

Verify at the official NPI Registry.