NPIMap

Individual provider Active NPI

Gregory Aaron Wallman, DO

  • Internal Medicine Physician
  • Glenview, IL
National Provider Identifier
1043324643
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036107048 Issued in IL
Practice address
2501 Compass Rd
Suite 100
Glenview, IL 60026-8000
Phone
(847) 901-5200
Fax
(847) 904-4907
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036107048 IL Primary

Addresses

Primary practice location

2501 Compass Rd
Suite 100
Glenview, IL 60026-8000

Mailing address

2501 Compass Rd
Suite 100
Glenview, IL 60026-8000
Phone (847) 901-5200

Other identifiers 3

IdentifierTypeStateIssuer
1912186024OtherILGROUP NPI
216024OtherILGROUP PTAN
26-1093600OtherILGROUP FEIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050829000514 IL Practitioner - Internal Medicine 2365473444 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Covenant Medical Group, LLCGroup PAC ID 8426139130, 8 clinicians

Practice addresses (Care Compare)

2501 Compass Rd
Suite 100
Glenview, IL 60026-8000
Phone (847) 901-5200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, LLC Internal Medicine CurrentSince Jan 1, 2008 Accepting new patients
Endeavor Health Medical Group CurrentSince Apr 5, 2020 Accepting new patients
Endeavor Health Medical Group Internal Medicine Current Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

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

2501 Compass Rd
Ste 100
Glenview, IL 60026
Phone (847) 869-1499

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGEJAA/Endpoint/HGEJAA

Organizations & group practices 3

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1043324643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 COMPASS RD",
            "address_2": "SUITE 100",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268000",
            "telephone_number": "847-901-5200",
            "fax_number": "847-904-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 COMPASS RD",
            "address_2": "SUITE 100",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268000",
            "telephone_number": "847-901-5200",
            "fax_number": "847-904-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLMAN",
        "first_name": "GREGORY",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036107048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1912186024",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "216024",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP FEIN",
            "identifier": "26-1093600",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.