Individual provider Active NPI

Joseph Guan, MD, MPH

  • Internal Medicine Physician
  • Olympia Fields, IL
National Provider Identifier
1154986404
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036168139 Issued in IL
Practice address
3700 W 203Rd St Ste 301
Olympia Fields, IL 60461-1182
Phone
(708) 679-2850
Fax
(708) 503-3811
NPI assigned
May 2, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036168139 IL Primary
Internal Medicine Physician 207R00000X 125-077739 IL

Addresses

Primary practice location

3700 W 203Rd St Ste 301
Olympia Fields, IL 60461-1182

Mailing address

35318 Eagle Way
Chicago, IL 60678-1353
Phone (317) 528-4800

Other practice location 1

1950 W Polk St Ste 5210
Chicago, IL 60612-3723
Phone (312) 864-4462

Other practice location 2

600 S Paulina St
Chicago, IL 60612-3806
Phone (312) 942-7100

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
I20240724002701 IL Practitioner - Internal Medicine 0244631729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rush Medical College of Rush University, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Specialty Physicians of Illinois LLCGroup PAC ID 4183529456, 114 clinicians

Practice addresses (Care Compare)

3700 W 203Rd St
Suite 301
Olympia Fields, IL 60461-1182
Phone (708) 709-6295

Hospital & facility affiliations

  • Franciscan Home Care Home health agency, Olympia Fields, IL, CCN 147267
  • Franciscan Health Olympia & Chicago Heights Hospital, Olympia Fields, IL, CCN 140172
  • Franciscan Health Munster Hospital, Munster, IN, CCN 150165

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-077739ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physicians of Illinois, LLC Internal Medicine Current Accepting new patients
Specialty Physicians of Illinois, LLC CurrentSince Aug 22, 2024 Accepting new patients

Locations

35318 Eagle Way
Chicago, IL 60678

3700 W 203rd St
Ste 111
Olympia Fields, IL 60461
Phone (708) 679-2512

3700 W 203rd St
Ste 301
Olympia Flds, IL 60461
Phone (708) 679-2850

Organizations & group practices 2

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": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1154986404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35318 EAGLE WAY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606781353",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W 203RD ST STE 301",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611182",
            "telephone_number": "708-679-2850",
            "fax_number": "708-503-3811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 W Polk St Ste 5210",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123723",
            "country_code": "US",
            "telephone_number": "312-864-4462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 S Paulina St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123806",
            "country_code": "US",
            "telephone_number": "312-942-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUAN",
        "first_name": "JOSEPH",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-02",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036168139",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125-077739",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

Verify at the official NPI Registry.