Individual provider Active NPI

Marc Fine, MD

  • Gastroenterology Physician
  • Niles, IL
National Provider Identifier
1720172729
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036064590 Issued in IL
Practice address
7900 Milwaukee Ave
Suite 19
Niles, IL 60714-3159
Phone
(847) 318-9595
Fax
(847) 318-9599
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036064590 IL Primary

Addresses

Primary practice location

7900 Milwaukee Ave
Suite 19
Niles, IL 60714-3159

Mailing address

29373 Network PL
Chicago, IL 60673-1293

Other identifiers 2

IdentifierTypeStateIssuer
036064590MedicaidIL
100016029OtherILRAIL ROAD MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mfine205908@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MyAurora/api/FHIR/DSTU2

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
I20060112000171 IL Practitioner - Gastroenterology 9931122694

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
R Franklin University of Med & Sci/Chicago Medical School, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7900 Milwaukee Ave
Suite 19
Niles, IL 60714-3159

Hospital & facility affiliations

  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy131
Upper gastrointestinal (GI) endoscopy for acid reflux95

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19195AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Aug 11, 2014 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Aug 11, 2014 Accepting new patients
Team Physicians of Arizona PC Past Accepting new patients

Locations

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

29373 Network Pl
Chicago, IL 60673

7900 N Milwaukee Ave
Ste 19
Niles, IL 60714
Phone (847) 318-9595

1875 W Dempster St
Ste 410
Park Ridge, IL 60068
Phone (847) 318-9595

Organizations & group practices 3

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 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1720172729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 MILWAUKEE AVE",
            "address_2": "SUITE 19",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143159",
            "telephone_number": "847-318-9595",
            "fax_number": "847-318-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036064590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036064590",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "100016029",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfine205908@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7900 Milwaukee Ave",
            "address_2": "Suite 19",
            "city": "Niles",
            "state": "IL",
            "country_code": "US",
            "postal_code": "607143159",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MyAurora/api/FHIR/DSTU2",
            "affiliation": "N",
            "address_1": "7900 Milwaukee Ave",
            "address_2": "Suite 19",
            "city": "Niles",
            "state": "IL",
            "country_code": "US",
            "postal_code": "607143159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

Verify at the official NPI Registry.