Organization Active NPI

General Medicine of Illinois Physicians, P.C.

  • Internal Medicine Physician
  • Novi, MI
National Provider Identifier
1457526709
Registry record updated Nov 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GENERAL MEDICINE OF ILLINOIS PHYSICIANS, P.C.
Practice address
21333 Haggerty Rd
Suite 150
Novi, MI 48375-5510
Phone
(248) 662-0250
Fax
(248) 662-9844
NPI assigned
Apr 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2015

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

Authorized official

Name
Thomas Prose, M.D.NPI 1275648123
Title
President
Phone
(248) 662-0250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

21333 Haggerty Rd
Suite 150
Novi, MI 48375-5510

Mailing address

21333 Haggerty Rd
Suite 150
Novi, MI 48375-5510
Phone (248) 662-0250

National Provider Directory

National Provider Directory

Locations

921 Avenue G
Kentwood, LA 70444
Phone (985) 229-0717

1051 Robert Blvd
Slidell, LA 70458
Phone (866) 661-1794

Practitioners & affiliated clinicians

Practitioners 1

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": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448409600000",
    "number": "1457526709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21333 HAGGERTY RD",
            "address_2": "SUITE 150",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483755510",
            "telephone_number": "248-662-0250",
            "fax_number": "248-662-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21333 HAGGERTY RD",
            "address_2": "SUITE 150",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483755510",
            "telephone_number": "248-662-0250",
            "fax_number": "248-662-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL MEDICINE OF ILLINOIS PHYSICIANS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2015-11-25",
        "status": "A",
        "authorized_official_last_name": "PROSE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-662-0250",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.