Active NPI
Edwin K Simon, M.D.
- Sleep Medicine (Psychiatry & Neurology) Physician
- Vernon Hills, IL
National Provider Identifier
1376503292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sleep Medicine (Psychiatry & Neurology) Physician
- License
- 36.10981
- Practice address
- 830 W End CT
Suite 400
Vernon Hills, IL 60061-1344 - Phone
- (847) 249-6910
- Fax
- (847) 249-6950
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036109810 | IL | |
| Sleep Medicine (Psychiatry & Neurology) Physician | 2084S0012X | 36.10981 | IL | Primary |
Addresses
Primary practice location
830 W End CT
Suite 400
Vernon Hills, IL 60061-1344
Mailing address
PO Box 610
North Chicago, IL 60064-0610
Phone (847) 473-4357
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036109810 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36.10981 | IL | MD | Sleep Medicine (Psychiatry & Neurology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rosalind Franklin University Health | Past | Accepting new patients | |
| Rosalind Franklin University of Medicine and Science | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- North Chicago, IL
- NPI 1982894911
-
- Clinical Medical Laboratory
- North Chicago, IL
- NPI 1073622254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255392000000",
"number": "1376503292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 610",
"city": "NORTH CHICAGO",
"state": "IL",
"postal_code": "600640610",
"telephone_number": "847-473-4357",
"fax_number": "847-578-8671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 W END CT",
"address_2": "SUITE 400",
"city": "VERNON HILLS",
"state": "IL",
"postal_code": "600611344",
"telephone_number": "847-249-6910",
"fax_number": "847-249-6950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "EDWIN",
"middle_name": "K",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2009-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036109810",
"primary": false
},
{
"code": "2084S0012X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Sleep Medicine",
"state": "IL",
"license": "36.10981",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036109810",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vernon Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.