Organization Active NPI

Robert H Geller, MD SC

  • Specialist
  • Elmhurst, IL
National Provider Identifier
1508977034
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036055119 Issued in IL
Legal business name
ROBERT H GELLER, MD SC
Practice address
1200 S York Street, Suite 4240
Elmhurst, IL 60126-5651
Phone
(708) 450-0462
Fax
(708) 632-5602
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Authorized official

Name
Mr. Jacob A Mathew
Title
Business Office Manager
Phone
(708) 632-5600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 036055119 IL Primary

Addresses

Primary practice location

1200 S York Street, Suite 4240
Elmhurst, IL 60126-5651

Mailing address

P.O. Box 7230
Westchester, IL 60154-7230
Phone (708) 632-5600

Other identifiers 2

IdentifierTypeStateIssuer
036055119MedicaidIL
1326068677OtherILNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060921000059 IL Part B Supplier - Clinic/Group Practice 6002811361 Receives reassigned benefits from 1 practitioner
Practice locations: Elmhurst, IL

National Provider Directory

National Provider Directory

Locations

675 W North Ave
Ste 609
Melrose Park, IL 60160
Phone (708) 450-5770

Practitioners & affiliated clinicians

Practitioners 2

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1508977034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 7230",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601547230",
            "telephone_number": "708-632-5600",
            "fax_number": "708-632-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S YORK STREET, SUITE 4240",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265651",
            "telephone_number": "708-450-0462",
            "fax_number": "708-632-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT H GELLER, MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "708-632-5600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036055119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036055119",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1326068677",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.