DR. RYAN BERNARD MITACEK MD
NPI 1639674211
Pediatrics - Pediatric Rheumatology in Chicago, IL
NPI Status: Active since March 27, 2018
Contact Information
5841 S MARYLAND AVE # MC5044
CHICAGO, IL
ZIP 60637
Phone: (773) 702-1000
- Individual
- Male
- Pediatrics
- Pediatric Rheumatology
- Accepts Insurance
- PECOS Enrolled
About RYAN MITACEK
This page provides the complete NPI Profile along with additional information for Ryan Mitacek, a pediatrician established in Chicago, Illinois with a medical specialization in Pediatrics, focusing in pediatric rheumatology . The healthcare provider is registered in the NPI registry with number 1639674211 assigned on March 2018. The practitioner's primary taxonomy code is 2080P0216X with license number 036.155959 (IL). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1639674211
- Provider Name
- DR. RYAN BERNARD MITACEK MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 5841 S MARYLAND AVE # MC5044 CHICAGO, IL 60637
- Location Phone
- (773) 702-1000
- Mailing Address
- 180 HARVESTER DR STE 110 BURR RIDGE, IL 60527
- Mailing Phone
- (773) 702-1150
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-27-2018
- Last Update Date
- 04-12-2024
- Code Navigator
A pediatrician like Ryan Mitacek is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Secondary Locations
- 3901 Beaubien St
Detroit, MI 48201
(313) 745-5870
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics Pediatric Rheumatology
- Taxonomy Code
- 2080P0216X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036.155959
- License State
- IL
- Taxonomy Description
- A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | 4301511663 (MI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Cross� Metro Detroit HMO Bronze Extra - HMO
- Blue Cross� Metro Detroit HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Select HMO Bronze Saver HSA - HMO
- Blue Cross� Select HMO Bronze Secure - HMO
- Blue Cross� Select HMO Silver - HMO
- Blue Cross� Select HMO Silver Extra - HMO
- Blue Cross� Select HMO Silver Saver - HMO
- Blue Cross� Select HMO Value - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Ryan Mitacek is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Reviews for DR. RYAN BERNARD MITACEK MD
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 3 | 9 | 6 | 7 | 4 | 2 | 1 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 6 | 9 | 12 | 7 | 8 | 2 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 6 + 9 + 1 + 2 + 7 + 8 + 2 + 2 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1639674211 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1417104274 | DR. DEIRDRE ITA DE RANIERI M.D. Individual | Pediatrics (Pediatric Rheumatology) | 5841 S MARYLAND AVE # MC5044 CHICAGO, IL 60637 (773) 834-1952 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639674211, enumerated in the NPI registry as an "individual" on March 27, 2018
The provider is located at 5841 S Maryland Ave # Mc5044 Chicago, Il 60637 and the phone number is (773) 702-1000
The provider's speciality is Pediatrics with taxonomy code 2080P0216X with a focus in Pediatric Rheumatology
The provider might be accepting Accepts: Blue Care Network of Michigan and Blue Cross Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
This NPI record was last updated on March 27, 2018. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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