NPIMap

Individual provider Active NPI

John C Elser, M.D.

  • Family Medicine Physician
  • Evergreen Park, IL
National Provider Identifier
1154366839
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036080970 Issued in IL
Practice address
2850 W 95TH St
Suite 101
Evergreen Park, IL 60805-2735
Phone
(708) 425-9550
Fax
(708) 229-6084
NPI assigned
Jun 18, 2006
Last updated
Jun 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036080970 IL Primary

Addresses

Primary practice location

2850 W 95TH St
Suite 101
Evergreen Park, IL 60805-2735

Mailing address

2850 W 95TH St
Suite 101
Evergreen Park, IL 60805-2735
Phone (708) 425-9550

Other identifiers 1

IdentifierTypeStateIssuer
036080970MedicaidIL

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
I20031201000513 IL Practitioner - Family Practice 6901701259 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

2800 W 95TH St
Evergreen, IL 60805-2701
Phone (708) 499-2070

2850 W 95TH St
Evergreen Park, IL 60805-2703

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036080970ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Little Company of Mary Affiliated Services Inc Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Little Company of Mary Affiliated Services Inc CurrentSince Jul 1, 2012 Accepting new patients
Osf Multi-Specialty Group CurrentSince Feb 1, 2020 Accepting new patients

Locations

2800 W 87th St
Chicago, IL 60652
Phone (312) 423-4200

2800 W 95th St
Evergreen Pk, IL 60805
Phone (708) 229-5104

2850 W 95th St
Ste 101
Evergreen Pk, IL 60805
Phone (708) 425-9550

12450 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 448-1207

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 4

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 12

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1154366839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST",
            "address_2": "SUITE 101",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052735",
            "telephone_number": "708-425-9550",
            "fax_number": "708-229-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST",
            "address_2": "SUITE 101",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052735",
            "telephone_number": "708-425-9550",
            "fax_number": "708-229-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSER",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036080970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036080970",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.