Individual provider Active NPI

Peter J. Johnson, MD

  • Obstetrics & Gynecology Physician
  • Elk Grove Village, IL
National Provider Identifier
1053517151
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036127758 Issued in IL
Practice address
800 Biesterfield Rd
2010
Elk Grove Village, IL 60007-3361
Phone
(847) 981-6500
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MDR5274 HI
Obstetrics & Gynecology Physician 207V00000X 036127758 IL Primary

Addresses

Primary practice location

800 Biesterfield Rd
2010
Elk Grove Village, IL 60007-3361

Mailing address

800 Biesterfield Rd
2010
Elk Grove Village, IL 60007-3361
Phone (847) 981-6500

Other identifiers 1

IdentifierTypeStateIssuer
036127758MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address peter.johnson.1@380.direct.athenahealth.com

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
I20120828000280 IL Practitioner - Obstetrics/Gynecology 7012164957 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bonaventure Medical Foundation LLCGroup PAC ID 7517863178, 164 clinicians
Access Community Health NetworkGroup PAC ID 9537076112, 182 clinicians

Practice addresses (Care Compare)

1555 Barrington Rd
Hoffman Estates, IL 60169-1019
Phone (847) 490-6945

1555 Barrington Rd
BLDG 1
Hoffman Estates, IL 60169-1020
Phone (847) 490-4222

1786 Moon Lake Blvd
Hoffman Est, IL 60194-5029
Phone (847) 755-8208

8321 W N Ave
Melrose Park Family Health Center
Melrose Park, IL 60160-1605
Phone (708) 681-2298

Hospital & facility affiliations

  • Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258
  • St Alexius Medical Center Hospital, Hoffman Estates, IL, CCN 140290
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDR5274HIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network CurrentSince Jan 8, 2018 Accepting new patients
Access Community Health Network CurrentSince Jan 8, 2018 Accepting new patients
Bonaventure Medical Foundation, LLC CurrentSince Apr 1, 2022 Accepting new patients
Access Community Health Network Current Accepting new patients
Access Community Health Network Past Accepting new patients

Locations

600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000

800 Biesterfield Rd
Ste 2010
Elk Grove Village, IL 60007
Phone (847) 640-1411

1555 N Barrington Rd
Ste 410
Hoffman Estates, IL 60169
Phone (847) 781-1894

1555 N Barrington Rd
Ste 335
Hoffman Estates, IL 60169
Phone (847) 839-0900

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

1786 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (847) 640-5640

8321 W North Ave
Melrose Park, IL 60160
Phone (708) 681-2298

190 W Irving Park Rd
Wood Dale, IL 60191
Phone (630) 766-0412

Organizations & group practices 5

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1053517151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "2010",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-981-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "2010",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-981-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PETER",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "HI",
            "license": "MDR5274",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036127758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036127758",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "peter.johnson.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "800 Biesterfield Rd",
            "address_2": "2010",
            "city": "Elk Grove Village",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600073361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.