| Simone Crivellaro, MD | |
|
820 S Wood St, Chicago, IL 60612-4325 | |
| (312) 996-9331 | |
| Not Available |
| Full Name | Simone Crivellaro |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 24 Years |
| Location | 820 S Wood St, Chicago, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730382201 | NPI | - | NPPES |
| Q73007 | Medicaid | SC | |
| 5907682 | Medicaid | NC | |
| AETNA | Other | NC | 9286104 |
| 1730382201 | Medicaid | VA | |
| 202774 | Other | NC | MEDCOST |
| 147F0 | Other | NC | BCBS |
| 3810009657 | Medicaid | WV | |
| 812200 | Other | NC | PARTNERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 2007-00873 (North Carolina) | Secondary |
| 208800000X | Urology | 036174667 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| University Of Illinois Hospital | Chicago, IL | Hospital |
| Mt Sinai Hospital Medical Center | Chicago, IL | Hospital |
| Ottawa Regional Hospital Dba Osf Saint Elizabeth Mdl Ctr | Ottawa, IL | Hospital |
| Holy Cross Hospital | Chicago, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Board Of Trustees Of The University Of Illinois | 3072422716 | 1058 |
| Mount Sinai Community Foundation | 5991600405 | 232 |
| Entity Name | The Board Of Trustees Of The University Of Illinois |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134118649 PECOS PAC ID: 3072422716 Enrollment ID: O20031201000484 |
| Entity Name | Mount Sinai Community Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376715896 PECOS PAC ID: 5991600405 Enrollment ID: O20040202001032 |
| Mailing Address | Practice Location Address |
|---|---|
| Simone Crivellaro, MD 820 S Wood St, Chicago, IL 60612-4325 Ph: (312) 996-9331 | Simone Crivellaro, MD 820 S Wood St, Chicago, IL 60612-4325 Ph: (312) 996-9331 |
Dr. Itay Sagy, M.D Urology Medicare: Not Enrolled in Medicare Practice Location: 5758 S Maryland Ave, Chicago, IL 60637 Phone: 773-702-1860 | |
Dr. Dylan Samuel Isaacson, MD, MPH Urology Medicare: Medicare Enrolled Practice Location: 251 E Huron St, Chicago, IL 60611 Phone: 312-694-6083 | |
Fadi A Habib, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 5600 W Addison St, Suite 305, Chicago, IL 60634 Phone: 773-725-0760 Fax: 773-725-3499 | |
Dr. Michael Ryan Abern, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 820 S Wood St # Mc955, Suite 515, Chicago, IL 60612 Phone: 312-996-9330 | |
Samuel John Ohlander, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 1009 S Wood St, Chicago, IL 60612 Phone: 312-996-2779 | |
Sarah Ann Armitage, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 1725 W Harrison St Ste 970, Chicago, IL 60612 Phone: 312-563-3447 | |
Mr. Minh Nguyen Pham, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 251 E Huron St, Chicago, IL 60611 Phone: 312-926-2000 |