Atkinson Clinic SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036978646 Issued in IL

Legal business name

ATKINSON CLINIC SC

Practice address

100 N Atkinson Rd Ste 207
Grayslake, IL 60030-7804

Phone

(847) 548-9777

Fax

(847) 548-9797

NPI assigned

Aug 9, 2006

Last updated

Aug 21, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sergei Shevlyagin, MDNPI 1235123589

Title

Owner

Phone

(847) 548-9777

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sergei Shevlyagin, MD

  • Internal Medicine Physician
  • Mundelein, IL
  • NPI 1235123589
  Medicare reassignment NPD Authorized official
• Inna Hoffman, APN

  • Family Nurse Practitioner
  • Highland Park, IL
  • NPI 1568982742
  Medicare reassignment NPD

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345507200000",
    "number": "1437169646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ATKINSON RD STE 207",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600307804",
            "telephone_number": "847-548-9777",
            "fax_number": "847-548-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ATKINSON RD STE 207",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600307804",
            "telephone_number": "847-548-9777",
            "fax_number": "847-548-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATKINSON CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2012-08-21",
        "status": "A",
        "authorized_official_last_name": "SHEVLYAGIN",
        "authorized_official_first_name": "SERGEI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-548-9777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036978646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036978646",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/SHIELD",
            "identifier": "4927894",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110224169",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lura J Arnold, D.C.
• Graciela Arroyo, LPC
• As Gordon Enterprise LLC
• Athletico LTD (Athletico Sports Medicine and Physical Therapy)
• Atkinson Chiropractic and Acupuncture SC
• Justin E Atkinson, D.C.
• Allison Augsburger, RDN, LDN, CLT
• Anita T Avila, MD
• Howard Axe, MD
• Jeffrey Marlin Babiuk, D.D.S.

• Internal Medicine Physician in Grayslake, IL
• Providers in Grayslake, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.