Active NPI
Andre Bieniarz, M.D.
- Maternal & Fetal Medicine Physician
- Chicago, IL
National Provider Identifier
1922162551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal & Fetal Medicine Physician
- License
- 036-055479
- Practice address
- 820 S. Wood St.
M/C 808
Chicago, IL 60612-7313 - Phone
- (312) 996-7300
- Fax
- (312) 996-4238
- NPI assigned
- Dec 20, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Maternal & Fetal Medicine Physician | 207VM0101X | 036-055479 | IL | Primary |
Addresses
Primary practice location
820 S. Wood St.
M/C 808
Chicago, IL 60612-7313
Mailing address
820 S. Wood St.
M/C 808
Chicago, IL 60612-7313
Phone (312) 996-7300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036055479 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-055479 | IL | MD | Maternal & Fetal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382486400000",
"number": "1922162551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 S. WOOD ST.",
"address_2": "M/C 808",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127313",
"telephone_number": "312-996-7300",
"fax_number": "312-996-4238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 S. WOOD ST.",
"address_2": "M/C 808",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127313",
"telephone_number": "312-996-7300",
"fax_number": "312-996-4238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIENIARZ",
"first_name": "ANDRE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-20",
"last_updated": "2013-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "IL",
"license": "036-055479",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036055479",
"state": "IL"
}
],
"endpoints": [],
"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 Oct 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.