Mark A Rudberg, MD MPH

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036078815 Issued in IL

Practice address

800 N Westmoreland Rd
Ste 101
Lake Forest, IL 60045-1687

Phone

(847) 234-6363

Fax

(847) 234-3233

NPI assigned

Sep 7, 2006

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 AZ

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

Medical College of Wisconsin, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Allied Physicians LLCGroup PAC ID 7618972514, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
• Northwest Medical Center Hospital, Tucson, AZ, CCN 030085

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Northwest Allied Physicians LLC

  • General Practice Physician
  • Tucson, AZ
  • NPI 1003833179

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Northwest Allied Physicians, LLC

  • Durable Medical Equipment & Medical Supplies
  • Oro Valley, AZ
  • NPI 1821302910
  NPD
• Richard J Siebert, M.D.,S,C.

  • Internal Medicine Physician
  • Lake Forest, IL
  • NPI 1003022088
  NPD (past)

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

• Northwestern Lake Forest Hospital

  • General Acute Care Hospital
  • Lake Forest, IL
  • NPI 1124025176
  Care Compare affiliation
• Northwest Hospital LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1487607784
  Care Compare affiliation

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1295838647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "SUITE 101",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451673",
            "telephone_number": "847-234-6363",
            "fax_number": "847-234-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "STE 101",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451687",
            "telephone_number": "847-234-6363",
            "fax_number": "847-234-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDBERG",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036078815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Brian Ross, DDS
• Kimberly Rossin, PA
• Thea Justine Rossmiller, MSW, LCSW
• Sabrina Carlins Roth, PA-C
• Leslie S Rubeck, APRN, CNM
• Bradley E Ruff, M.D.,
• Kimberly Rusesky
• Vicki B Russell, RN
• Sara J Ryan-Jetha, M.S., CF-SLP
• Robert A Ryan, M.D.

• Internal Medicine Physician in Lake Forest, IL
• Providers in Lake Forest, 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 Mar 11, 2014; 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.