Michael G Close MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036086407 Issued in IL

Legal business name

MICHAEL G CLOSE MD PC

Practice address

5137 N Broadway St
Chicago, IL 60640-3009

Phone

(773) 243-0010

Fax

(773) 243-0015

NPI assigned

Jan 7, 2009

Last updated

Jan 7, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James Miedema

Title

Manager

Phone

(773) 243-0010

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231286400000",
    "number": "1235376690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5137 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403009",
            "telephone_number": "773-243-0010",
            "fax_number": "773-243-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5137 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403009",
            "telephone_number": "773-243-0010",
            "fax_number": "773-243-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL G CLOSE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-01-07",
        "status": "A",
        "authorized_official_last_name": "MIEDEMA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-243-0010"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036086407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086407",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1622969",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michael J. Reinstein M.D PC (Community Mental Health Services)

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.