Individual provider Active NPI

Michelle N Conroy, DO

  • Pediatrics Physician
  • Elmhurst, IL
National Provider Identifier
1023160710
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036112574 Issued in IL
Practice address
1200 S York St Ste 2000
Elmhurst, IL 60126-5634
Phone
(331) 221-9002
Fax
(331) 221-2747
NPI assigned
Jan 16, 2007
Last updated
May 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036112574 IL Primary

Addresses

Primary practice location

1200 S York St Ste 2000
Elmhurst, IL 60126-5634

Mailing address

4201 Winfield Rd FL 4
Warrenville, IL 60555-4025
Phone (331) 221-6377

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mconroy41733@direct.edward.org Direct

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
I20080626000075 IL Practitioner - Pediatric Medicine 0749352334 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036112574ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Apr 23, 2024 Accepting new patients
Endeavor Health Medical Group Pediatrics CurrentSince Apr 23, 2024 Accepting new patients
Wyse Eyecare SC Past Accepting new patients
Elmhurst Memorial Healthcare PastSince May 25, 2021 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

1200 S York St
Elmhurst, IL 60126
Phone (331) 221-5678

1200 S York St
Ste 2000
Elmhurst, IL 60126
Phone (331) 221-9002

172 E Schiller St
Elmhurst, IL 60126
Phone (630) 782-4050

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Interoperability endpoints

  • Direct secure messaging: mconroy41733@direct.edward.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1023160710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 WINFIELD RD FL 4",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554025",
            "telephone_number": "331-221-6377",
            "fax_number": "331-221-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST STE 2000",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265634",
            "telephone_number": "331-221-9002",
            "fax_number": "331-221-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONROY",
        "first_name": "MICHELLE",
        "middle_name": "N",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036112574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mconroy41733@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1200 S York St Ste 2000",
            "city": "Elmhurst",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601265634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.