Individual provider Active NPI

Alvin Tom George, MD

  • Gastroenterology Physician
  • Chicago, IL
National Provider Identifier
1023633138
Registry record updated Jun 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036.164029 Issued in IL
Practice address
5841 S Maryland Ave # Mc4076
Chicago, IL 60637-1443
Phone
(773) 702-6140
NPI assigned
Jun 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2022041238 MO
Gastroenterology Physician 207RG0100X 036.164029 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave # Mc4076
Chicago, IL 60637-1443

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20200723002836 MO Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8820412745

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

150 Harvester Dr
Suite 300
Burr Ridge, IL 60527-5919

150 Harvester Dr
Suite 300
Burr Ridge, IL 60527-5965

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022041238MOMDInternal Medicine Physician
036.164029ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Chicago CurrentSince Jul 1, 2026 Accepting new patients
Washington University Physicians in Illinois, Inc PastSince Jun 1, 2020 Accepting new patients

Locations

180 Harvester Dr
Ste 110
Burr Ridge, IL 60527
Phone (773) 702-1061

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687046400000",
    "number": "1023633138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC4076",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-702-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "ALVIN",
        "middle_name": "TOM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-15",
        "last_updated": "2023-06-18",
        "certification_date": "2023-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2022041238",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036.164029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.