Individual provider Active NPI

Robert C Kaiser, M.D.

  • Gastroenterology Physician
  • Homewood, IL
National Provider Identifier
1255362000
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036062816 Issued in IL
Practice address
17901 Governors Hwy
Suite 208
Homewood, IL 60430-1144
Phone
(708) 799-3305
Fax
(708) 799-7220
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 036062816 IL Primary

Addresses

Primary practice location

17901 Governors Hwy
Suite 208
Homewood, IL 60430-1144

Mailing address

17901 Governors Hwy
Suite 208
Homewood, IL 60430-1144
Phone (708) 799-3305

Other identifiers 1

IdentifierTypeStateIssuer
036062816MedicaidIL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101217000566 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 1759469604 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Gastroenterology Group, LLC Gastroenterology CurrentSince Jul 1, 2021 Accepting new patients
Elgin Gastroenterology SC Gastroenterology Current Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients
Northwest Gastroenterologists SC Current Accepting new patients
Gi Partners of Illinois, PLLC Gastroenterology CurrentSince Jan 1, 2017 Accepting new patients

Locations

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

17901 Governors Hwy
Ste 106
Homewood, IL 60430
Phone (708) 799-3305

1880 W Winchester Rd
Ste 201
Libertyville, IL 60048
Phone (847) 247-0187

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

16240 Prince Dr
South Holland, IL 60473
Phone (708) 331-0011

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255362000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17901 GOVERNORS HWY",
            "address_2": "SUITE 208",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301144",
            "telephone_number": "708-799-3305",
            "fax_number": "708-799-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 GOVERNORS HWY",
            "address_2": "SUITE 208",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301144",
            "telephone_number": "708-799-3305",
            "fax_number": "708-799-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISER",
        "first_name": "ROBERT",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036062816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036062816",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

Verify at the official NPI Registry.