Individual provider Active NPI

Richard S. Rock, MD

  • Gynecology Physician
  • Bannockburn, IL
National Provider Identifier
1609984830
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
0360569624 Issued in IL
Practice address
2101 Waukegan Rd
Suite 301
Bannockburn, IL 60015-1836
Phone
(847) 295-0584
Fax
(847) 295-0637
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 0360569624 IL Primary

Addresses

Primary practice location

2101 Waukegan Rd
Suite 301
Bannockburn, IL 60015-1836

Mailing address

2101 Waukegan Rd
Suite 301
Bannockburn, IL 60015-1836
Phone (847) 295-0584

Other identifiers 1

IdentifierTypeStateIssuer
36059624MedicaidIL

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
I20081212000099 IL Practitioner - Obstetrics/Gynecology 0042371742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
R Franklin University of Med & Sci/Chicago Medical School, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2101 Waukegan Rd
Suite 301
Bannockburn, IL 60015-1836
Phone 84729505841836

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
29.46 of 100Reported as individual
Quality
20
Improvement activities
0
Cost
71.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0360569624ILMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Offices of Richard S. Rock M D Gynecology CurrentSince Apr 1, 1996 Accepting new patients

Locations

2101 Waukegan Rd
Ste 301
Bannockburn, IL 60015
Phone (847) 295-0584

900 N Westmoreland Rd
Ste 223
Lake Forest, IL 60045
Phone (847) 295-0584

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EAHHBA/Endpoint/EAHHBA

Organizations & group practices 1

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 7

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1609984830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 WAUKEGAN RD",
            "address_2": "SUITE 301",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151836",
            "telephone_number": "847-295-0584",
            "fax_number": "847-295-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 WAUKEGAN RD",
            "address_2": "SUITE 301",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151836",
            "telephone_number": "847-295-0584",
            "fax_number": "847-295-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCK",
        "first_name": "RICHARD",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "0360569624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36059624",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bannockburn, IL

Sources for this page

Verify at the official NPI Registry.