NPIMap

Individual provider Active NPI

Ilya Isaakovich Fishman, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Elk Grove Village, IL
National Provider Identifier
1346434578
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
036.118688 Issued in IL
Practice address
800 Biesterfield Rd
Eberle Medical Office Building, Suite 605
Elk Grove Village, IL 60007-3361
Phone
(847) 364-6724
Fax
(847) 364-6720
NPI assigned
Aug 30, 2007
Last updated
Apr 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.118688 IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036.118688 IL Primary

Addresses

Primary practice location

800 Biesterfield Rd
Eberle Medical Office Building, Suite 605
Elk Grove Village, IL 60007-3361

Mailing address

800 Biesterfield Rd
Suite 3007
Elk Grove Village, IL 60007-3361
Phone (847) 290-6513

Other identifiers 2

IdentifierTypeStateIssuer
1316169949OtherILNPI, TYPE 2
1407219504OtherILORGANIZATIONAL NPI

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
I20070910000299 IL Practitioner - Geriatric MedicinePractitioner - Internal Medicine 8729171632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

800 Biesterfield Rd
Suite 3007
Elk Grove Village, IL 60007-3371
Phone (847) 290-6513

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.53 of 100Reported as individual
Quality
57.27
Improvement activities
40
Cost
75.4

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.118688ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Adult Healthcare LLC Internal Medicine CurrentSince Mar 24, 2016 Accepting new patients
Alexian Brothers Medical Center Past Accepting new patients

Locations

800 W Oakton St
Arlington Hts, IL 60004
Phone (847) 253-3710

800 Biesterfield Rd
Ste 3007
Elk Grove Vlg, IL 60007
Phone (847) 301-1377

800 Biesterfield Rd
Ste 605
Elk Grove Vlg, IL 60007
Phone (847) 364-6724

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

Organizations & group practices 2

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1346434578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "SUITE 3007",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-290-6513",
            "fax_number": "847-290-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "EBERLE MEDICAL OFFICE BUILDING, SUITE 605",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-364-6724",
            "fax_number": "847-364-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHMAN",
        "first_name": "ILYA",
        "middle_name": "ISAAKOVICH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-30",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.118688",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036.118688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI, TYPE 2",
            "identifier": "1316169949",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATIONAL NPI",
            "identifier": "1407219504",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.