Individual provider Active NPI

Trask A Printz, D.O.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1982167110
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4778 Issued in TN
Practice address
2320 E 93Rd St Ste 3610
Chicago, IL 60617-3909
Phone
(312) 609-0300
Fax
(773) 967-5942
NPI assigned
Apr 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4778 TN Primary
Family Medicine Physician 207Q00000X 036172314 IL

Addresses

Primary practice location

2320 E 93Rd St Ste 3610
Chicago, IL 60617-3909

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

102 E Ravine Rd
Kingsport, TN 37660-3814
Phone (432) 245-9600

Other practice location 2

208 Medical Park Blvd
Bristol, TN 37620-7343
Phone (423) 989-4050

Other practice location 3

917 W Walnut St
Johnson City, TN 37604-6527
Phone (423) 439-6464

Other identifiers 1

IdentifierTypeStateIssuer
Q050585MedicaidTN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tprintz413869@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220902002739 TN Practitioner - Family Practice 2264768886 Reassigns benefits to 1 organization
I20241114000173 IL Practitioner - Family Practice 2264768886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

2320 E 93Rd St
Chicago, IL 60617-3909
Phone (773) 967-3999

836 W Wellington
Suite G346
Chicago, IL 60657-5147
Phone (773) 296-7147

836 W Wellington Ave
Chicago, IL 60657-5147

Hospital & facility affiliations

  • Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048
  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4778TNMDCounselor
036172314ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health & Hospitals Corporation CurrentSince Nov 6, 2024 Accepting new patients
Medical Education Assistance Corporation Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Dec 22, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Nov 6, 2024 Accepting new patients
Medical Education Assistance Corporation Family Medicine PastSince Sep 25, 2019 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

2320 E 93rd St
Ste 3610
Chicago, IL 60617

29373 Network Pl
Chicago, IL 60673

917 W Walnut St
Johnson City, TN 37604
Phone (423) 439-6464

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

102 E Ravine Rd
Kingsport, TN 37660
Phone (423) 245-9600

Interoperability endpoints

  • Direct secure messaging: tprintz413869@direct.myadvocateaurora.org

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1982167110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 E 93RD ST STE 3610",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606173909",
            "telephone_number": "312-609-0300",
            "fax_number": "773-967-5942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 E Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603814",
            "country_code": "US",
            "telephone_number": "432-245-9600",
            "fax_number": "423-245-9634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "208 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207343",
            "country_code": "US",
            "telephone_number": "423-989-4050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "917 W Walnut St",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046527",
            "country_code": "US",
            "telephone_number": "423-439-6464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRINTZ",
        "first_name": "TRASK",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "4778",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036172314",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q050585",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tprintz413869@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2320 E 93rd St Ste 3610",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606173909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2320 E 93rd St Ste 3610",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606173909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.