Individual provider Active NPI

Zachrey Rosengarten, M.D.

  • Diagnostic Radiology Physician
  • Northbrook, IL
National Provider Identifier
1114378007
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-159035 Issued in IL
Practice address
2602 Mulberry LN
Northbrook, IL 60062-5937
Phone
(847) 878-9109
NPI assigned
Jun 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036-159035 IL Primary
Internal Medicine Physician 207R00000X 125.068378 IL

Addresses

Primary practice location

2602 Mulberry LN
Northbrook, IL 60062-5937

Mailing address

900 Rand Rd Ste 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220718002918 IL Practitioner - Diagnostic Radiology 0446544944 Reassigns benefits to 1 organization
I20241105001673 WI Practitioner - Diagnostic Radiology 0446544944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diaspora Radiology SCGroup PAC ID 0547501942, 6 clinicians

Practice addresses (Care Compare)

2602 Mulberry LN
Northbrook, IL 60062-5937
Phone (847) 878-9109

3004 Golf Rd
Suite 101a
Eau Claire, WI 54701-8794
Phone (855) 694-3300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-159035ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diaspora Radiology, SC Diagnostic Radiology CurrentSince May 1, 2022 Accepting new patients
Illinois Bone and Joint Institute LLC Past Accepting new patients
Smart Scan Medical Imaging - Eau Claire, LLC PastSince Aug 15, 2024 Accepting new patients

Locations

3004 Golf Rd
Ste 101
Eau Claire, WI 54701
Phone (608) 690-7210

3004 Golf Rd
Ste 101A
Eau Claire, WI 54701
Phone (847) 878-9109

8307 Murphy Dr
Middleton, WI 53562
Phone (608) 690-7210

2106 Schofield Ave
Ste 7
Weston, WI 54476
Phone (608) 690-7210

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1114378007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 MULBERRY LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600625937",
            "telephone_number": "847-878-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENGARTEN",
        "first_name": "ZACHREY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-159035",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.068378",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.