Active NPI
Michael W Debre, MD
- Internal Medicine Physician
- Merrionette Park, IL
National Provider Identifier
1215044508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036053268
- Practice address
- 11600 S Kedzie Ave
Suite B
Merrionette Park, IL 60803-6307 - Phone
- (708) 684-6867
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036053268 | IL | Primary |
Addresses
Primary practice location
11600 S Kedzie Ave
Suite B
Merrionette Park, IL 60803-6307
Mailing address
11600 S Kedzie Ave
Suite B
Merrionette Park, IL 60803-6307
Phone (708) 684-6867
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36053268 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036053268 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James G Elipas DPM PC | Past | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Past | Accepting new patients |
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.
-
dba Advocate Medical Group
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
dba Ankle & Foot Specialist
- Foot & Ankle Surgery Podiatrist
- Merrionette Park, IL
- NPI 1811126584
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372118400000",
"number": "1215044508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11600 S KEDZIE AVE",
"address_2": "SUITE B",
"city": "MERRIONETTE PARK",
"state": "IL",
"postal_code": "608036307",
"telephone_number": "708-684-6867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11600 S KEDZIE AVE",
"address_2": "SUITE B",
"city": "MERRIONETTE PARK",
"state": "IL",
"postal_code": "608036307",
"telephone_number": "708-684-6867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBRE",
"first_name": "MICHAEL",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2013-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036053268",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36053268",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Merrionette Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.