John W Matseshe, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036047991 Issued in IL

Practice address

1445 N Hunt Club Rd Ste 303
Gurnee, IL 60031-2603

Phone

(847) 855-3150

NPI assigned

May 31, 2005

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• John W Matseshe MD PLLC

  • Gastroenterology Physician
  • Gurnee, IL
  • NPI 1487284881
  NPD Authorized official

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1194727420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 FARRINGTON DR",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600692504",
            "telephone_number": "847-855-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 N HUNT CLUB RD STE 303",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312603",
            "telephone_number": "847-855-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSESHE",
        "first_name": "JOHN",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036047991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036047991",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taras Martyniouk, D.M.D.
• Brenda Marwede, LCPC
• Jennifer Mateo
• Shaina Mathews, OD
• Mary Caitlin Mathewson, BCBA
• John Gottfried Mayer, MD
• Mary McCabe, PTA
• Rachel McCauley
• Jim I McClure, M.D.
• Kayla Lynn McCollor, LMT

• Gastroenterology Physician in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.