Individual provider Active NPI

Michele I Slogoff, MD

  • Surgery Physician
  • Geneva, IL
National Provider Identifier
1659440097
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036111435 Issued in IL
Practice address
1665 South St
Geneva, IL 60134-2542
Phone
(630) 208-7874
Fax
(630) 208-7880
NPI assigned
Nov 7, 2006
Last updated
Jul 30, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036111435 IL Primary
Colon & Rectal Surgery Physician 208C00000X 036111435 IL

Addresses

Primary practice location

1665 South St
Geneva, IL 60134-2542

Mailing address

1665 South St
Geneva, IL 60134-2542
Phone (630) 208-7874

Other identifiers 1

IdentifierTypeStateIssuer
036111435MedicaidIL

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
I20040927001157 IL Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 1254300270 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036111435ILMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgery Group SC Surgery CurrentSince Aug 1, 2014 Accepting new patients
Loyola University Physician Foundation Past Accepting new patients

Locations

1665 South St
Geneva, IL 60134
Phone (630) 208-7874

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1659440097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 SOUTH ST",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342542",
            "telephone_number": "630-208-7874",
            "fax_number": "630-208-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 SOUTH ST",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342542",
            "telephone_number": "630-208-7874",
            "fax_number": "630-208-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOGOFF",
        "first_name": "MICHELE",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036111435",
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": "036111435",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111435",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.