Individual provider Active NPI

Michael K Raymond

  • Internal Medicine Physician
  • Skokie, IL
National Provider Identifier
1265479422
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036067244 Issued in IL
Practice address
9650 Gross Point Rd
1900
Skokie, IL 60076-1234
Phone
(847) 676-1112
Fax
(847) 674-3358
NPI assigned
May 31, 2006
Last updated
Feb 25, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036067244 IL Primary

Addresses

Primary practice location

9650 Gross Point Rd
1900
Skokie, IL 60076-1234

Mailing address

9650 Gross Point Rd
1900
Skokie, IL 60076-1234
Phone (847) 676-1112

Other identifiers 1

IdentifierTypeStateIssuer
036067244MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Internal Medicine CurrentSince Nov 1, 2015 Accepting new patients
Endeavor Health Medical Group CurrentSince Jan 1, 2009 Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Jan 1, 2009 Accepting new patients
Arthritis & Internal Medicine Specialist PastSince Jan 1, 1987 Accepting new patients

Locations

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

75 Remittance Dr
Dept 1611
Chicago, IL 60675

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

9650 Gross Point Rd
Ste 1900
Skokie, IL 60076
Phone (224) 251-2020

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1265479422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9650 GROSS POINT RD",
            "address_2": "1900",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761234",
            "telephone_number": "847-676-1112",
            "fax_number": "847-674-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 GROSS POINT RD",
            "address_2": "1900",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761234",
            "telephone_number": "847-676-1112",
            "fax_number": "847-674-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036067244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036067244",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.