NPIMap

Individual provider Active NPI

Michael Harris, MD

  • Internal Medicine Physician
  • Greenville, IL
National Provider Identifier
1083716476
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036073471 Issued in IL
Practice address
200 Health Care Dr
Greenville, IL 62246-1154
Phone
(618) 664-1230
NPI assigned
Sep 5, 2006
Last updated
May 10, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

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 036073471 IL Primary
Hospitalist Physician 208M00000X 036073471 IL

Addresses

Primary practice location

200 Health Care Dr
Greenville, IL 62246-1154

Mailing address

2525 S Michigan Ave
Chicago, IL 60616-2315
Phone (312) 567-2000

Other practice location 1

2525 S Michigan Ave
Chicago, IL 60616-2315
Phone (312) 567-2000

Other identifiers 2

IdentifierTypeStateIssuer
036073471MedicaidIL
0031603775OtherILBLUE CROSS BLUE SHIELD

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
I20040512000036 IL Practitioner - Internal Medicine 3072502277 Reassigns benefits to 2 organizations
Practice locations: Olympia Fields, IL

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Howard University College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

503 N Maple St
Effingham, IL 62401-2006
Phone (217) 342-2121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.63
Improvement activities
40
Cost
81.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036073471ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital of the Hospital Sisters of the Third Order of St F CurrentSince Jan 20, 2026 Accepting new patients
Cep America-Illinois Hospitalists Hospitalist CurrentSince Apr 1, 2018 Accepting new patients
Cep America-Illinois Hospitalists, LLP Internal Medicine CurrentSince Apr 1, 2018 Accepting new patients

Locations

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121

200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808

12866 Troxler Ave
Highland, IL 62249
Phone (618) 651-2600

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1083716476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162315",
            "telephone_number": "312-567-2000",
            "fax_number": "312-328-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HEALTH CARE DR",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622461154",
            "telephone_number": "618-664-1230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 S Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606162315",
            "country_code": "US",
            "telephone_number": "312-567-2000",
            "fax_number": "312-328-7724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036073471",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036073471",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036073471",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0031603775",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, IL

Sources for this page

Verify at the official NPI Registry.