Individual provider Active NPI

Ryan Jeffrey Gluth, D.O

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1609307305
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036150444 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Mar 23, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036150444 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

319 NW 42ND Way
Deerfield Beach, FL 33442-8088
Phone (954) 673-7926

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
I20190909000052 IL Practitioner - Emergency Medicine 2365714425 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036150444ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Mar 1, 2021 Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince Sep 1, 2019 Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince Sep 1, 2019 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 3, 2020 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 3, 2020 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1609307305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 NW 42ND WAY",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334428088",
            "telephone_number": "954-673-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLUTH",
        "first_name": "RYAN",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036150444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.