NPIMap

Individual provider Active NPI

Kevin Liebovich, MD

  • Gastroenterology Physician
  • Gurnee, IL
National Provider Identifier
1235131673
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036-106282 Issued in IL
Practice address
20 Tower CT
Suite C
Gurnee, IL 60031-5711
Phone
(847) 244-2960
Fax
(847) 244-2986
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036-106282 IL Primary

Addresses

Primary practice location

20 Tower CT
Suite C
Gurnee, IL 60031-5711

Mailing address

20 Tower CT
Suite C
Gurnee, IL 60031-5711
Phone (847) 244-2960

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address kliebovich235839@direct.myadvocateaurora.org Direct
Direct Messaging Address GIAMidwest-LSG@directaddress.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050211000509 IL Practitioner - Gastroenterology 3678525227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Loyola University of Chicago, Stritch School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Illinois Gastroenterology Group LLCGroup PAC ID 5193857423, 116 clinicians

Practice addresses (Care Compare)

20 Tower Court C
Gurnee, IL 60031-5711
Phone (847) 244-2960

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.21 of 100Reported as group
Quality
67.65
Promoting interoperability
99
Improvement activities
40
Cost
80.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy147
Upper gastrointestinal (GI) endoscopy for acid reflux155

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-106282ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients
Northwest Gastroenterologists SC Current Accepting new patients
Elgin Gastroenterology SC Gastroenterology Current Accepting new patients
Illinois Gastroenterology Group, LLC Gastroenterology CurrentSince Jun 1, 2010 Accepting new patients
Lake Shore Gastroenterology Gastroenterology PastSince Jun 1, 2010 Accepting new patients
Lake Shore Gastroenterolgy SC Gastroenterology Past Accepting new patients

Locations

1100 W Central Rd
Arlington Hts, IL 60005
Phone (847) 259-2410

745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362

20 Tower Ct
Ste C
Gurnee, IL 60031
Phone (847) 244-2960

806 Central Ave
Ste 202
Highland Park, IL 60035
Phone (847) 433-9840

101 Waukegan Rd
Ste 980
Lake Bluff, IL 60044
Phone (847) 457-1060

755 S Milwaukee Ave
Ste 195
Libertyville, IL 60048
Phone (847) 367-4277

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

Interoperability endpoints

  • Direct secure messaging: kliebovich235839@direct.myadvocateaurora.org

Organizations & group practices 6

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.

Hospital & facility affiliations 7

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1235131673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 TOWER CT",
            "address_2": "SUITE C",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315711",
            "telephone_number": "847-244-2960",
            "fax_number": "847-244-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 TOWER CT",
            "address_2": "SUITE C",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315711",
            "telephone_number": "847-244-2960",
            "fax_number": "847-244-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBOVICH",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036-106282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "20 Tower Ct",
            "address_2": "Suite C",
            "city": "Gurnee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600315711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kliebovich235839@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "20 Tower Ct",
            "address_2": "Suite C",
            "city": "Gurnee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600315711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GIAMidwest-LSG@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "20 Tower Ct",
            "address_2": "Suite C",
            "city": "Gurnee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600315711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

Verify at the official NPI Registry.