Individual provider Active NPI

John G Grieco, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Downers Grove, IL
National Provider Identifier
1023074770
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
036057662 Issued in IL
Practice address
2650 Warrenville Rd
Suite 280
Downers Grove, IL 60515
Phone
(630) 324-7900
Fax
(630) 324-7942
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 01052200 IN
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 036057662 IL Primary

Addresses

Primary practice location

2650 Warrenville Rd
Suite 280
Downers Grove, IL 60515

Mailing address

2650 Warrenville Rd
Suite 280
Downers Grove, IL 60515
Phone (630) 324-7900

Other identifiers 3

IdentifierTypeStateIssuer
526620OtherCOOK GROUP
344390OtherDUPAGE GROUP
36057662MedicaidIL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050117000039 IL Practitioner - Cardiac SurgeryPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Thoracic Surgery 5496667669

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01052200INMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Interoperability endpoints

  • Direct secure messaging: jgrieco21807@direct.edward.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1023074770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 WARRENVILLE RD",
            "address_2": "SUITE 280",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "60515",
            "telephone_number": "630-324-7900",
            "fax_number": "630-324-7942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 WARRENVILLE RD",
            "address_2": "SUITE 280",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "60515",
            "telephone_number": "630-324-7900",
            "fax_number": "630-324-7942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIECO",
        "first_name": "JOHN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "01052200",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036057662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COOK GROUP",
            "identifier": "526620",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DUPAGE GROUP",
            "identifier": "344390",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36057662",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.