Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ETHAN UNGCHUSRI
NPI 1437656683
Radiology - Vascular & Interventional Radiology in Chicago, IL

Q: What is Ethan Ungchusri's NPI number?

The NPI number for Ethan Ungchusri is 1437656683. It was assigned to this individual provider in the NPPES registry on April 12, 2018.

Q: What is Ethan Ungchusri's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Vascular & Interventional Radiology, with taxonomy code 2085R0204X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Ungchusri was last updated on October 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 12, 2018PECOS EnrolledAccepts Medicare Assignment

5841 S MARYLAND AVE, CHICAGO, IL 60637(773) 702-3550 Get Directions Write a Review

NPPES record last updated: October 12, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 12, 2026, Sep 21, 2026, Sep 1, 2026 and 3 more (6 updates tracked since 2018).

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About Ethan Ungchusri NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN UNGCHUSRI (NPI 1437656683) is an individual vascular & interventional radiology provider in Chicago, Illinois, licensed in Illinois (036171306) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS, is affiliated with The University Of Chicago Medical Center, and maintains 8 additional practice locations.

NPPES Registry Identity

NPI1437656683

Entity TypeIndividualMale

Primary Taxonomy2085R0204X

Provider Legal NameETHAN UNGCHUSRI

Location Address5841 S MARYLAND AVEChicago, IL 60637

Mailing Address150 Harvester Dr Ste 300Burr Ridge, IL 60527-5965

Phone(773) 702-3550

Sole ProprietorNo

Medical School CMSTexas Tech University Health Science Center School Of MedicineGraduated 2018

Enumeration DateApril 12, 2018

Last NPPES UpdateOctober 12, 20266 updates tracked since enumeration

NPPES CertifiedOctober 12, 2026

✔ NPI 1437656683 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Vascular & Interventional RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0204X

Licenses✔ Licensed in IL · 036171306✔ Licensed in IN · 01093443A

Definition

A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

5841 S MARYLAND AVE, Chicago, IL 60637

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Secondary Practice Locations 8

Location 11959 NE Pacific StSeattle, WA 98195-0001 · Phone (206) 543-3687

Location 21870 W Winchestr Rd Ste 146Libertyville, IL 60048-5359 · Phone (847) 584-3959

Location 3534 Roxbury RdRockford, IL 61107-5076 · Phone (847) 584-3959

Location 4630 Dundee Rd Ste 200Northbrook, IL 60062-2765 · Phone (224) 407-4400 · Fax (224) 407-2255

Location 5950 Technology Way Ste 250Libertyville, IL 60048-5366 · Phone (224) 407-4400 · Fax (224) 407-2255

Location 65875 E Riverside BlvdRockford, IL 61114-4937 · Phone (815) 398-9491 · Fax (815) 381-7498

Location 79410 Calumet Ave Ste 302Munster, IN 46321-0018 · Phone (847) 584-3959

Location 81550 N Randall RdElgin, IL 60123-7876 · Phone (815) 398-9491 · Fax (815) 381-7498

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ethan Ungchusri is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800139759

PECOS Enrollment IDI20240918001015, I20250124002505

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Ethan Ungchusri reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The University Of Chicago Medical Center

Same address

General Acute Care Hospital

5841 S MARYLAND AVE
Chicago, IL 60637

Reassigned Medicare billing, Illinois enrollment
1,905 clinicians in this Medicare group

NPI 1033218128 (773) 702-1530

University Of Chicago

Same address

Multi-Specialty

5841 S MARYLAND AVE, UCPG/MC 1099
Chicago, IL 60637

Reassigned Medicare billing, Illinois and Indiana enrollments
Also billed through NPI 1477262046 (Illinois)
2,237 clinicians in this Medicare group

NPI 1821048786 (773) 702-9200

Joint And Vascular Institute Indiana LLC

18 mi

Vascular & Interventional Radiology

9410 CALUMET AVE STE 302
Munster, IN 46321

Reassigned Medicare billing, Indiana enrollment
3 clinicians in this Medicare group

NPI 1932065356 (847) 584-3959

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 17

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of chest, 1 view 71045

A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.

206 services162 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

79 services78 patients

Ct scan of abdomen and pelvis with contrast 74177

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

51 services50 patients

Ct scan of chest without contrast 71250

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

47 services47 patients

Ct scan of chest with contrast 71260

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

37 services37 patients

Limited ultrasound scan of abdomen 76705

A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.

24 services24 patients

Ct scan of chest with contrast 71260

22 services22 patients

Ct scan of chest without contrast 71250

20 services20 patients

X-ray of abdomen, 1 view 74018

An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.

20 services16 patients

Ct scan of blood vessels of chest with contrast 71275

A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.

18 services18 patients

Ct scan of abdomen and pelvis without contrast 74176

A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.

17 services17 patients

X-ray of chest, 2 views 71046

16 services16 patients

Ct scan of abdomen and pelvis with contrast 74177

16 services16 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

13 services13 patients

Ultrasound scan of head and neck soft tissue 76536

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

12 services12 patients

Ultrasound scan of head and neck soft tissue 76536

11 services11 patients

Fluoroscopic guidance for insertion or removal of central vein access device 77001

Fluoroscopic guidance for central vein access device insertion or removal is a procedure where a special X-ray, called a fluoroscope, is used to help accurately place or remove a device in a central vein. This device aids in delivering medications or collecting blood samples.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

The University Of Chicago Medical Center

Acute Care Hospitals · Chicago, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140088

Location5841 South MarylandChicago, IL 60637 · Cook County

Emergency services Birthing friendly

Franciscan Health Olympia & Chicago Heights

Acute Care Hospitals · Olympia Fields, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140172

Location20201 S Crawford AvenueOlympia Fields, IL 60461 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60637 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DON MARTINEZ M.D.

Radiology (Diagnostic Radiology)