Hosep H Deyrmenjian, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036079535 Issued in IL

Practice address

1445 Hunt Club Rd
Ste 303
Gurnee, IL 60031

Phone

(847) 855-3150

Fax

(847) 855-6006

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1710979729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 HUNT CLUB RD",
            "address_2": "STE 303",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315257",
            "telephone_number": "847-855-3150",
            "fax_number": "847-855-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 HUNT CLUB RD",
            "address_2": "STE 303",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "60031",
            "telephone_number": "847-855-3150",
            "fax_number": "847-855-6006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6440 Grand Ave",
            "address_2": "Suite 205",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "600315257",
            "country_code": "US",
            "telephone_number": "847-855-3150",
            "fax_number": "847-855-3143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEYRMENJIAN",
        "first_name": "HOSEP",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036079535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036079535",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.