Individual provider Active NPI

George Herman Roepke III

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1154765790
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036138697 Issued in IL
Practice address
711 W North Ave
Suite 209
Chicago, IL 60610-1174
Phone
(312) 280-0996
NPI assigned
Apr 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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 036138697 IL Primary

Addresses

Primary practice location

711 W North Ave
Suite 209
Chicago, IL 60610-1174

Mailing address

1000 Remington Blvd
Suite 100
Bolingbrook, IL 60440-5114
Phone (630) 914-2714

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
I20160906000736 IL Practitioner - Family Practice 5193011948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presence Healthcare ServicesGroup PAC ID 2860396769, 69 clinicians

Practice addresses (Care Compare)

2233 W Division St
Chicago, IL 60622-8151
Phone (312) 770-2000

2845 N Sheridan Rd
Chicago, IL 60657-7227

331 W Surf St
Chicago, IL 60657-7227

711 W N Ave
Chicago, IL 60610-1042

Hospital & facility affiliations

  • Presence Saint Joseph Hospital - Chicago Hospital, Chicago, IL, CCN 140224
  • Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080
  • Saint Joseph Hospital-Elgin Hospital, Elgin, IL, CCN 140217

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Presence Healthcare Services Family Medicine Current Accepting new patients
Presence Healthccare Services Family Medicine CurrentSince Jun 13, 2022 Accepting new patients
Presence Healthcare Services Past Accepting new patients

Locations

1000 Remington Blvd
Ste 100
Bolingbrook, IL 60440
Phone (630) 914-2417

331 W Surf St
Ste 805
Chicago, IL 60657

711 W North Ave
Ste 209
Chicago, IL 60610
Phone (312) 280-0996

62311 Collection Ctr Dr
Chicago, IL 60693

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.

Hospital & facility affiliations 3

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": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1154765790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 REMINGTON BLVD",
            "address_2": "SUITE 100",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405114",
            "telephone_number": "630-914-2714",
            "fax_number": "630-214-2469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W NORTH AVE",
            "address_2": "SUITE 209",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101174",
            "telephone_number": "312-280-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEPKE",
        "first_name": "GEORGE",
        "middle_name": "HERMAN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-25",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036138697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.