Individual provider Active NPI

Eric J Yegelwel, MD

  • Gastroenterology Physician
  • Arlington Heights, IL
National Provider Identifier
1093760415
Registry record updated Dec 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036.069591 Issued in IL
Practice address
3405 N Arlington Heights Road
Arlington Heights, IL 60004
Phone
(847) 577-9300
Fax
(847) 577-9318
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.069591 IL
Gastroenterology Physician 207RG0100X 036069591 IL
Gastroenterology Physician 207RG0100X 036.069591 IL Primary

Addresses

Primary practice location

3405 N Arlington Heights Road
Arlington Heights, IL 60004

Mailing address

3405 N Arlington Heights Road
Arlington Heights, IL 60004
Phone (847) 577-9300

Other identifiers 1

IdentifierTypeStateIssuer
036069591MedicaidIL

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
I20100730000544 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 7315836244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
76.06 of 100Reported as individual
Quality
90.21
Promoting interoperability
99
Improvement activities
40
Cost
30.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.069591ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical, S.C. Internal Medicine CurrentSince Jan 1, 1987 Accepting new patients

Locations

3405 N Arlington Heights Rd
Arlington Heights, IL 60004
Phone (847) 577-9300

3405 N Arlington Heights Rd
#R
Arlington Heights, IL 60004
Phone (312) 577-9300

Organizations & group practices 1

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514246400000",
    "number": "1093760415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 N ARLINGTON HEIGHTS ROAD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "60004",
            "telephone_number": "847-577-9300",
            "fax_number": "847-577-9318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 N ARLINGTON HEIGHTS ROAD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "60004",
            "telephone_number": "847-577-9300",
            "fax_number": "847-577-9318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEGELWEL",
        "first_name": "ERIC",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2017-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.069591",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036069591",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036.069591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036069591",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.