Organization Active NPI

Procare Medical Group LLC

  • General Practice Physician
  • Northbrook, IL
National Provider Identifier
1407308752
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
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

Updated by the provider on Nov 2, 2016

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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 NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2127679Procare Medical Group LLC3000 Dundee Road, Suite 313, Northbrook, IL 60062Certificate of waiverMar 15, 2027

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.