Active NPI
Andrew Tannenbaum, M.D.
- Vascular & Interventional Radiology Physician
- Harvard, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular & Interventional Radiology Physician
- License
- 036147111
- Practice address
- 901 Grant St
Harvard, IL 60033-1821 - Phone
- (815) 943-5431
- Fax
- (815) 943-0659
- NPI assigned
- Jun 29, 2012
- Last updated
- Apr 1, 2026
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 252241 | MA | |
| Diagnostic Radiology Physician | 2085R0202X | 252241 | MA | |
| Vascular & Interventional Radiology Physician | 2085R0204X | 036147111 | IL | Primary |
Addresses
Primary practice location
901 Grant St
Harvard, IL 60033-1821
Mailing address
901 Grant St
Harvard, IL 60033-1821
Phone (815) 943-5431
Other practice location 1
1 Boston Medical Ctr Pl
Dept of Radiology - FGH Bldg
Boston, MA 02118-2908
Phone (617) 638-8000
Other practice location 2
1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000
Other practice location 3
1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000
Other practice location 4
8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-5000
Other practice location 5
875 South Route 31
Crystal Lake, IL 60014
Phone (779) 220-5500
Other practice location 6
2000 Lake Ave
Woodstock, IL 60098-7401
Phone (815) 337-7100
Other practice location 7
3922 Mercy Dr
McHenry, IL 60050-3179
Phone (815) 344-4499
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
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Boston University School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2400 N Rockton Ave
Rockford, IL 61103-3655
Phone (815) 971-5000
901 Grant St
Harvard, IL 60033-1821
Phone (815) 943-5431
Hospital & facility affiliations
- Javon Bea Hospital
- Mercyhealth Hospital & Physician Clinic-Crystal la
- Mercy Health System Corp
- CGH Medical Center
- Mercy Harvard Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 14 |
| Leg revascularization (restoring blood flow) | 11 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 252241 | MA | MD | Diagnostic Radiology Physician |
| 036147111 | IL | MD | Vascular & Interventional Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rockford Health Physicians | Current | Accepting new patients | |
| RMH Pathologists, LTD | Current | Accepting new patients | |
| Singleton Associates PA | Diagnostic Radiology | Current | Accepting new patients |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Specialists in Medical Imaging SC | Diagnostic Radiology | Current | Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
875 S State Route 31
Crystal Lake, IL 60014
Phone (779) 220-5500
348 S Division St
Harvard, IL 60033
Phone (815) 943-1122
901 Grant St
Harvard, IL 60033
Phone (815) 943-2961
3922 Mercy Dr
McHenry, IL 60050
Phone (815) 344-4499
600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310
8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066
2000 Lake Ave
Woodstock, IL 60098
Phone (815) 337-4116
Interoperability endpoints
- atannenbaum63286@direct.mhemail.org
Organizations & group practices 7
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 Mercyhealth Physicians
- Multi-Specialty Clinic/Center
- Rockford, IL
- NPI 1043242886
-
dba MHS Physician Services
- Multi-Specialty Clinic/Center
- Janesville, WI
- NPI 1598718603
IL
-
- Diagnostic Radiology Physician
- Olympia Fields, IL
- NPI 1841687951
-
dba FHN-Memorial Hospital
- General Acute Care Hospital
- Freeport, IL
- NPI 1447228788
-
- Anatomic Pathology Physician
- Rockford, IL
- NPI 1184671992
-
dba Mercy Walworth Hospital and Medical Center
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sterling, IL
- NPI 1902854623
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1629118609
-
dba Mercyhealth Hospital and Physician Clinic-Crystal Lake
- General Acute Care Hospital
- Crystal Lake, IL
- NPI 1023754371
-
- Critical Access Hospital
- Harvard, IL
- NPI 1427001445
-
dba Mercy Hospital Janesville
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775001600000",
"number": "1972867315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 GRANT ST",
"city": "HARVARD",
"state": "IL",
"postal_code": "600331821",
"telephone_number": "815-943-5431",
"fax_number": "815-943-0659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 GRANT ST",
"city": "HARVARD",
"state": "IL",
"postal_code": "600331821",
"telephone_number": "815-943-5431",
"fax_number": "815-943-0659"
}
],
"practiceLocations": [
{
"address_1": "1 Boston Medical Ctr Pl",
"address_2": "Dept of Radiology - FGH Bldg",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021182908",
"country_code": "US",
"telephone_number": "617-638-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1045 W Stephenson St",
"address_purpose": "LOCATION",
"city": "Freeport",
"state": "IL",
"postal_code": "610324864",
"country_code": "US",
"telephone_number": "815-599-6000",
"fax_number": "815-599-7974",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1045 W Stephenson St",
"address_purpose": "LOCATION",
"city": "Freeport",
"state": "IL",
"postal_code": "610324864",
"country_code": "US",
"telephone_number": "815-599-6000",
"fax_number": "815-599-7974",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8201 E Riverside Blvd",
"address_purpose": "LOCATION",
"city": "Rockford",
"state": "IL",
"postal_code": "611142300",
"country_code": "US",
"telephone_number": "815-971-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "875 South Route 31",
"address_purpose": "LOCATION",
"city": "Crystal Lake",
"state": "IL",
"postal_code": "60014",
"country_code": "US",
"telephone_number": "779-220-5500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2000 Lake Ave",
"address_purpose": "LOCATION",
"city": "Woodstock",
"state": "IL",
"postal_code": "600987401",
"country_code": "US",
"telephone_number": "815-337-7100",
"fax_number": "815-337-4793",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3922 Mercy Dr",
"address_purpose": "LOCATION",
"city": "McHenry",
"state": "IL",
"postal_code": "600503179",
"country_code": "US",
"telephone_number": "815-344-4499",
"fax_number": "815-344-4779",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TANNENBAUM",
"first_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-29",
"last_updated": "2026-04-01",
"certification_date": "2026-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "252241",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "252241",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "IL",
"license": "036147111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Harvard, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.