Philip G Grandinetti, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036087271 Issued in IL

Practice address

6322 N Cicero Ave
Chicago, IL 60646-4422

Phone

(773) 736-8088

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1083766372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6322 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464422",
            "telephone_number": "773-736-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6322 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464422",
            "telephone_number": "773-736-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDINETTI",
        "first_name": "PHILIP",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036087271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087271",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD OF",
            "identifier": "01605424",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hilda Granda
• Bre'Shae Grandberry, LCSW
• Matthew Ryan Grande
• Catherine M Grandi
• Debora M Grandinetti, M.D.
• Samuel Grandinetti, DDS
• Vickie Julie Grandinetti, D.D.S.
• Kenisha Quiana Grandison, NP
• Ronni Grandison, LMT
• Grandview Health Partners, LTD.

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.