Individual provider Active NPI

John Thomas Berry, D.O.

  • Rheumatology Physician
  • Skokie, IL
National Provider Identifier
1417319690
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036.148627 Issued in IL
Practice address
4709 Golf Rd Ste 300
Skokie, IL 60076-1233
Phone
(847) 869-7233
NPI assigned
Mar 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 036.148627 IL Primary

Addresses

Primary practice location

4709 Golf Rd Ste 300
Skokie, IL 60076-1233

Mailing address

4709 Golf Rd Ste 300
Skokie, IL 60076-1233
Phone (847) 869-7233

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
I20190517000005 IL Practitioner - Internal Medicine 6507159654 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of New England, College of Osteo Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedics and Rheumatology of the North Shore SCGroup PAC ID 4981707494, 7 clinicians

Practice addresses (Care Compare)

4709 Golf Rd
Suite 300
Skokie, IL 60076-1233
Phone (847) 869-7233

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.148627ILMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedics & Rheumatology of the North Shore SC CurrentSince Aug 1, 2022 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince May 25, 2019 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince May 25, 2019 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

1775 Ballard Rd
Park Ridge, IL 60068
Phone (847) 318-6020

4709 Golf Rd
Ste 1200
Skokie, IL 60076
Phone (847) 869-7233

4709 Golf Rd
Ste 300
Skokie, IL 60076
Phone (847) 869-7233

Organizations & group practices 3

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 7

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": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1417319690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD STE 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761233",
            "telephone_number": "847-869-7233",
            "fax_number": "847-869-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD STE 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761233",
            "telephone_number": "847-869-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-25",
        "last_updated": "2022-07-07",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036.148627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.