Active NPI
Procare Medical Group LLC
- General Practice Physician
- Northbrook, IL
National Provider Identifier
1407308752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- PROCARE MEDICAL GROUP LLC
- Practice address
- 3000 Dundee Rd
Suite 311
Northbrook, IL 60062-2422 - Phone
- (847) 383-6224
- NPI assigned
- Nov 2, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alexander Green
- Title
- General Manager
- Phone
- (847) 494-0127
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| General Practice Physician | 208D00000X | Primary |
Addresses
Primary practice location
3000 Dundee Rd
Suite 311
Northbrook, IL 60062-2422
Mailing address
1601 Tahoe Circle Dr
Wheeling, IL 60090-5137
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2127679 | Procare Medical Group LLC | Certificate of waiver | Mar 15, 2027 |
National Provider Directory
National Provider DirectoryLocations
3000 Dundee Rd
Ste 313
Northbrook, IL 60062
Phone (847) 383-6224
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Skokie, IL
- NPI 1225076953
-
- Family Nurse Practitioner
- Northbrook, IL
- NPI 1790076495
-
- Clinical Psychologist
- Northbrook, IL
- NPI 1407179302
-
- Professional Counselor
- Northbrook, IL
- NPI 1447566625
-
- Professional Counselor
- Highland Park, IL
- NPI 1295389948
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478044800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1478044800000",
"number": "1407308752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 TAHOE CIRCLE DR",
"city": "WHEELING",
"state": "IL",
"postal_code": "600905137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 DUNDEE RD",
"address_2": "SUITE 311",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600622422",
"telephone_number": "847-383-6224"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROCARE MEDICAL GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-11-02",
"last_updated": "2016-11-02",
"status": "A",
"authorized_official_last_name": "GREEN",
"authorized_official_first_name": "ALEXANDER",
"authorized_official_title_or_position": "GENERAL MANAGER",
"authorized_official_telephone_number": "847-494-0127"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"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 Nov 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.