Gregg R Fenske, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036057101 Issued in IL

Practice address

1555 Barrington Rd
Suite 3450
Hoffman Estates, IL 60194-1019

Phone

(847) 882-2400

Fax

(847) 884-7222

NPI assigned

Mar 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Poplar Creek Family Practice

  • Family Medicine Physician
  • Hoffman Estates, IL
  • NPI 1376661199
  NPD (past)

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093833873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 BARRINGTON RD",
            "address_2": "SUITE 3450",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601941019",
            "telephone_number": "847-882-2400",
            "fax_number": "847-884-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 BARRINGTON RD",
            "address_2": "SUITE 3450",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601941019",
            "telephone_number": "847-882-2400",
            "fax_number": "847-884-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENSKE",
        "first_name": "GREGG",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036057101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36057101",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Faber, NNP
• Family Care Home Health LLC
• Famous LLC
• Rachel Fanella
• Ingy Raof Farag, DO
• Carla Ferguson, FNP
• David Fernquist, MOT, OTR/L
• Lee Ferrenbach, LAC
• Azalia Ferrer Dominguez
• Stephanie Ann Ferrille, APN

• Family Medicine Physician in Hoffman Estates, IL
• Providers in Hoffman Estates, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.