NPIMap

Individual provider Active NPI

Glynn J Elliott III, MD

  • Internal Medicine Physician
  • Wilmette, IL
National Provider Identifier
1366481426
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-092139 Issued in IL
Practice address
1921 Lake Ave Ste a
Wilmette, IL 60091-1480
Phone
(847) 464-9050
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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 036-092139 IL Primary

Addresses

Primary practice location

1921 Lake Ave Ste a
Wilmette, IL 60091-1480

Mailing address

1921 Lake Ave Ste a
Wilmette, IL 60091-1480
Phone (847) 464-9050

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gelliott7607@ce-direct.presencehealth.org

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
I20050919000689 IL Practitioner - Internal Medicine 0143123075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore Physicians Group PLLCGroup PAC ID 6901309053, 3 clinicians

Practice addresses (Care Compare)

1921 Lake Ave
Suite a
Wilmette, IL 60091-1480
Phone (847) 464-9050

Hospital & facility affiliations

  • Home Healthcare Solutions Company LLC Home health agency, Oak Lawn, IL, CCN 147930
  • Residential Home Health Home health agency, Northbrook, IL, CCN 147001
  • Access Life Care, LTD Home health agency, Northbrook, IL, CCN 148267
  • Aspire Home Healthcare, LLC Home health agency, Morton Grove, IL, CCN 148139
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-092139ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Physicians Group PLLC Internal Medicine CurrentSince Jun 19, 2025 Accepting new patients
Endeavor Health Medical Group Past Accepting new patients
North Shore Physicians Group, LLC Past Accepting new patients
North Shore Physicians Group, LLC Past Accepting new patients

Locations

100 N River Rd
Des Plaines, IL 60016
Phone (847) 297-1800

1921 Lake Ave
Ste A
Wilmette, IL 60091
Phone (847) 256-4434

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1366481426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 LAKE AVE STE A",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911480",
            "telephone_number": "847-464-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 LAKE AVE STE A",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911480",
            "telephone_number": "847-464-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "GLYNN",
        "middle_name": "J",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-092139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gelliott7607@ce-direct.presencehealth.org",
            "affiliation": "N",
            "address_1": "1625 Sheridan Rd Ste 1F",
            "city": "Wilmette",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600911824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

Verify at the official NPI Registry.