Individual provider Active NPI

Gregory Stanley Podolej, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1407296270
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125-062641 Issued in IL
Practice address
5841 S. Maryland Ave. MC 5068
University of Chicago, Section of Emergency Medicine
Chicago, IL 60637
Phone
(773) 702-9500
NPI assigned
Jun 26, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125-062641 IL Primary

Addresses

Primary practice location

5841 S. Maryland Ave. MC 5068
University of Chicago, Section of Emergency Medicine
Chicago, IL 60637

Mailing address

1000 E 53Rd St
Unit 513 S.
Chicago, IL 60615-4369
Phone (847) 714-4123

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
I20180109000578 IL Practitioner - Emergency Medicine 9931428521 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • St Mary Medical Center Hospital, Galesburg, IL, CCN 140064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-062641ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2021 Accepting new patients
St Mary Medical Center CurrentSince Feb 26, 2019 Accepting new patients
St Mary Medical Center CurrentSince Feb 26, 2019 Accepting new patients
Saint Francis Medical Center CurrentSince Oct 21, 2017 Accepting new patients
Saint Francis Medical Center CurrentSince Oct 21, 2017 Accepting new patients

Locations

3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

1501 Hartford St
Lafayette, IN 47904
Phone (765) 423-6011

1701 S Creasy Ln
Lafayette, IN 47905
Phone (765) 502-4400

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1407296270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 53RD ST",
            "address_2": "UNIT 513 S.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154369",
            "telephone_number": "847-714-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S. MARYLAND AVE. MC 5068",
            "address_2": "UNIVERSITY OF CHICAGO, SECTION OF EMERGENCY MEDICINE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60637",
            "telephone_number": "773-702-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODOLEJ",
        "first_name": "GREGORY",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125-062641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.