NPIMap

Individual provider Active NPI

William Larsen

  • Medical Physician Assistant
  • Elk Grove Village, IL
National Provider Identifier
1356711584
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085005642 Issued in IL
Practice address
800 Biesterfield Rd
Elk Grove Village, IL 60007-3361
Phone
(847) 437-5500
NPI assigned
Sep 30, 2015
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085005642 IL Primary

Addresses

Primary practice location

800 Biesterfield Rd
Elk Grove Village, IL 60007-3361

Mailing address

800 Biesterfield Rd
Elk Grove Village, IL 60007-3361
Phone (847) 437-5500

Other practice location 1

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (773) 702-1000

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
I20151118000758 IL Practitioner - Physician Assistant 9537469846 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bonaventure Medical Foundation LLCGroup PAC ID 7517863178, 164 clinicians
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

1555 Barrington Rd
Hoffman Estates, IL 60169-1019
Phone (847) 490-6945

1786 Moon Lake Blvd
Hoffman Est, IL 60194-5029
Phone (847) 755-8208

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (888) 824-0200

800 Biesterfield Rd
Elk Grove Village, IL 60007-3361

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085005642ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Aug 25, 2018 Accepting new patients
The University of Chicago Medical Center CurrentSince Aug 25, 2018 Accepting new patients
Cepamerica Illinois LLP CurrentSince Dec 1, 2015 Accepting new patients
University of Chicago CurrentSince Aug 28, 2024 Accepting new patients
Cepamerica Illinois LLP CurrentSince Dec 1, 2015 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

600 S Randall Rd
Algonquin, IL 60102
Phone (224) 783-4300

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: william.larsen.2@380.direct.athenahealth.com

Organizations & group practices 7

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1356711584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-437-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-437-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371443",
            "country_code": "US",
            "telephone_number": "773-702-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-30",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085005642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.