Individual provider Active NPI

David Liebovitz, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1972564748
Registry record updated Mar 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036086253 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637-1447
Phone
(773) 702-6840
NPI assigned
Mar 31, 2006
Last updated
Mar 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036086253 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637-1447

Mailing address

180 Harvester Dr
Suite 110
Burr Ridge, IL 60527-7594
Phone (773) 702-1150

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
I20060426000850 IL Practitioner - Internal Medicine 1052321643 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1333 W Belmont Ave
Chicago, IL 60657-5785

1630 Sherman Ave
Evanston, IL 60201-3711

171 N Aberdeen St
Suite 100
Chicago, IL 60607-1669
Phone (312) 926-4150

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

4445 W Irving Park Rd
Chicago, IL 60641-2808

636 Raymond Dr
Suite 107
Naperville, IL 60563-9789
Phone (630) 416-2300

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036086253ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Mar 15, 2016 Accepting new patients
The University of Chicago Medical Center CurrentSince Mar 15, 2016 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 11, 2002 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 11, 2002 Accepting new patients
Central Dupage Physician Group Internal Medicine Past Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

Dept 5777
Carol Stream, IL 60122

675 N Saint Clair St
Ste 18-200
Chicago, IL 60611
Phone (312) 695-4525

680 N Lake Shore Dr
Ste 1015
Chicago, IL 60611
Phone (312) 926-9674

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Organizations & group practices 5

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 6

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1972564748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR",
            "address_2": "SUITE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605277594",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-702-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBOVITZ",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036086253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.