Grant Connell Hallock, DO

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

036.166239 Issued in IL

Practice address

1775 Dempster St
Park Ridge, IL 60068-1143

Phone

(847) 723-2210

Fax

(847) 723-6987

NPI assigned

Apr 1, 2020

Last updated

Mar 28, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NH

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

Specialty

Internal Medicine

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Incare LLCGroup PAC ID 1153658851, 62 clinicians

Incare Tufts PLLCGroup PAC ID 3072013192, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph Hospital Hospital, Nashua, NH, CCN 300011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: grant.hallock@hca6.eclinicaldirectplus.com
• FHIR API: https://api.platform.athenahealth.com/18780/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/CFFBDD

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.

• Incare LLC

  • Internal Medicine Physician
  • North Andover, MA
  • NPI 1639655467

  NH

  Medicare reassignment Care Compare group NPD
• Incare Tufts PLLC

  • Internal Medicine Physician
  • North Andover, MA
  • NPI 1164305611

  NH

  Medicare reassignment Care Compare group NPD
• St Joseph Hospital of Nashua NH

  • General Acute Care Hospital
  • Nashua, NH
  • NPI 1093787384
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Hospital of Nashua NH

  • General Acute Care Hospital
  • Nashua, NH
  • NPI 1093787384
  Care Compare affiliation
• St Joseph Hospital of Nashua NH

  dba St Joseph Hospital Urgent Care

  • Urgent Care Clinic/Center
  • Milford, NH
  • NPI 1437758679

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1225666357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1646 RIVER ST UNIT 701",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600168418",
            "telephone_number": "858-414-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 DEMPSTER ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681143",
            "telephone_number": "847-723-2210",
            "fax_number": "847-723-6987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLOCK",
        "first_name": "GRANT",
        "middle_name": "CONNELL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2024-03-28",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036.166239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bemnet Hailu, M.D.
• Nisha Prabha Hakhu, DO
• Ari Hakimian, DO
• Chance Chanice Haley, DO
• Sigrun Hallmeyer, MD
• Mary K. Halm, LCSW, PMH-C
• Lori Hamamoto, DPT
• Mohammed Nabeel Hameed, DNP
• Veena Hamill, MD
• Claude Winchester Hamilton, M.D.

• Critical Care Medicine (Internal Medicine) Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Critical Care Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.