Active NPI
Michael P Grossman, MD
- Diagnostic Radiology Physician
- Chicago, IL
National Provider Identifier
1477566990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Practice address
- 2929 S Ellis Ave
Chicago, IL 60616-3395 - Phone
- (312) 791-2000
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | IL | Primary |
Addresses
Primary practice location
2929 S Ellis Ave
Chicago, IL 60616-3395
Mailing address
2929 S Ellis Ave
Chicago, IL 60616-3395
Phone (312) 791-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04915653 | Other | IL | BLUE SHIELD ILLINOIS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036041084 | IL | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Medical Services Inc | Diagnostic Radiology | Past | Accepting new patients |
| Emergency Care Physician Services | Past | Accepting new patients | |
| Future Diagnostics, LTD. | Diagnostic Radiology | Past | Accepting new patients |
| Accurate Imaging Diagnostic, LTD. | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Diagnostic Radiology Physician
- Chicago, IL
- NPI 1861491474
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1568493294
-
- Diagnostic Radiology Physician
- Chicago, IL
- NPI 1194872457
-
- Diagnostic Radiology Physician
- Skokie, IL
- NPI 1609849827
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191974400000",
"number": "1477566990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2929 S ELLIS AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606163395",
"telephone_number": "312-791-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2929 S ELLIS AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606163395",
"telephone_number": "312-791-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSMAN",
"first_name": "MICHAEL",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2007-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD ILLINOIS",
"identifier": "04915653",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.