Individual provider Active NPI

Richard Nicolay III, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Glenview, IL
National Provider Identifier
1609239409
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
036-159957 Issued in IL
Practice address
2401 Ravine Way Ste 200
Glenview, IL 60025-7645
Phone
(847) 998-5680
Fax
(847) 998-6365
NPI assigned
Mar 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 036-159957 IL Primary
Orthopaedic Surgery Physician 207X00000X 036-159957 IL

Addresses

Primary practice location

2401 Ravine Way Ste 200
Glenview, IL 60025-7645

Mailing address

900 Rand Rd Ste 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976

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
I20221010001797 IL Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 2062704463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Indiana University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Illinois Bone and Joint Institute, LLCGroup PAC ID 6002814878, 603 clinicians

Practice addresses (Care Compare)

2401 Ravine Way
Suite 200
Glenview, IL 60025-7645
Phone (847) 998-5680

Hospital & facility affiliations

  • Aspire Home Healthcare, LLC Home health agency, Morton Grove, IL, CCN 148139
  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)12
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-159957ILMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute LLC Orthopaedic Surgery CurrentSince Oct 3, 2022 Accepting new patients
Illinois Bone and Joint Institute, LLC Orthopaedic Surgery CurrentSince Oct 3, 2022 Accepting new patients
Bruce Noxon, DPM, PC Past Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

2401 Ravine Way
Ste 200
Glenview, IL 60025
Phone (847) 998-5680

2401 Ravine Way
Ste 103
Glenview, IL 60025
Phone (847) 832-6006

1919 Skokie Valley Rd
Highland Park, IL 60035
Phone (224) 765-5500

9000 Waukegan Rd
Ste 200
Morton Grove, IL 60053

521 Green Bay Rd
Fl 2
Wilmette, IL 60091
Phone (847) 724-4864

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 3

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": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1609239409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 RAVINE WAY STE 200",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257645",
            "telephone_number": "847-998-5680",
            "fax_number": "847-998-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLAY",
        "first_name": "RICHARD",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-30",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "036-159957",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036-159957",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.