Individual provider Active NPI

Michael J Reicherts, MD

  • Pediatrics Physician
  • Naperville, IL
National Provider Identifier
1679536007
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036091664 Issued in IL
Practice address
4043 S Route 59
Naperville, IL 60564-5802
Phone
(630) 420-4275
Fax
(630) 420-8957
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036091664 IL Primary

Addresses

Primary practice location

4043 S Route 59
Naperville, IL 60564-5802

Mailing address

4043 S Route 59
Naperville, IL 60564-5802
Phone (630) 420-4275

Other identifiers 1

IdentifierTypeStateIssuer
036091664MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036091664ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael J. Reicherts, MD SC Pediatrics Current Accepting new patients
Ann & Robert H. Lurie Children'S Hospital of Chicago Current Accepting new patients

Locations

4043 S Route 59
Naperville, IL 60564
Phone (630) 299-4909

Interoperability endpoints

  • Direct secure messaging: mreicherts135029@direct.luriechildrens.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1679536007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4043 S ROUTE 59",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645802",
            "telephone_number": "630-420-4275",
            "fax_number": "630-420-8957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4043 S ROUTE 59",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645802",
            "telephone_number": "630-420-4275",
            "fax_number": "630-420-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICHERTS",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036091664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091664",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.