Individual provider Active NPI

Joel Greenman, MD

  • Obstetrics & Gynecology Physician
  • Northbrook, IL
National Provider Identifier
1376946178
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036-040444 Issued in IL
Practice address
3304 Lake Knoll Dr
Northbrook, IL 60062-6316
Phone
(847) 564-0976
Fax
(847) 564-5905
NPI assigned
Oct 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036-040444 IL Primary

Addresses

Primary practice location

3304 Lake Knoll Dr
Northbrook, IL 60062-6316

Mailing address

3304 Lake Knoll Dr
Northbrook, IL 60062-6316
Phone (847) 564-0976

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-040444ILMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1376946178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 LAKE KNOLL DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600626316",
            "telephone_number": "847-564-0976",
            "fax_number": "847-564-5905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 LAKE KNOLL DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600626316",
            "telephone_number": "847-564-0976",
            "fax_number": "847-564-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENMAN",
        "first_name": "JOEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-040444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.