Individual provider Active NPI

John L Holden, MD

  • Gastroenterology Physician
  • Downers Grove, IL
National Provider Identifier
1356341846
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036054681 Issued in IL
Practice address
3825 Highland Ave Suite 203
Downers Grove, IL 60515-1552
Phone
(630) 969-1167
Fax
(630) 969-1284
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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 036054681 IL Primary

Addresses

Primary practice location

3825 Highland Ave Suite 203
Downers Grove, IL 60515-1552

Mailing address

3825 Highland Ave Suite 203
Downers Grove, IL 60515-1552
Phone (630) 969-1167

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
I20080205000164 IL Practitioner - Gastroenterology 4880776442 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036054681ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation CurrentSince Jun 1, 2015 Accepting new patients
Mount Sinai Community Foundation Gastroenterology CurrentSince Jun 1, 2015 Accepting new patients
Gastroenterology Services, LTD Gastroenterology CurrentSince Dec 1, 2007 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Gastroenterology Services Endoscopy Suite, LTD Past Accepting new patients

Locations

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

3825 Highland Ave
Ste 20
Downers Grove, IL 60515

3825 Highland Ave
Ste 203
Downers Grove, IL 60515
Phone (630) 969-1167

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BABFBA

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1356341846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 HIGHLAND AVE SUITE 203",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151552",
            "telephone_number": "630-969-1167",
            "fax_number": "630-969-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 HIGHLAND AVE SUITE 203",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151552",
            "telephone_number": "630-969-1167",
            "fax_number": "630-969-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036054681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.