Walter R Grobelny Jr., M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036049787 Issued in IL

Practice address

700 Oak St
Suite 200
Winnetka, IL 60093-2566

Phone

(847) 446-1066

Fax

(847) 446-1825

NPI assigned

Sep 13, 2005

Last updated

Apr 19, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD (past)

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1740275015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OAK ST",
            "address_2": "SUITE 200",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600932566",
            "telephone_number": "847-446-1066",
            "fax_number": "847-446-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OAK ST",
            "address_2": "SUITE 200",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600932566",
            "telephone_number": "847-446-1066",
            "fax_number": "847-446-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROBELNY",
        "first_name": "WALTER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036049787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110006912",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Goldstein, LCSW
• Rena Goodfriend-Leve, M.D.
• Rachel Goodman, MD
• Ronna Gordon
• Janet Beth Goss, M.A., L.P.C.
• Grohmann Psychological Services, PLLC
• Dale Forrest Grooms, ATC
• Brooke V Grossblatt
• Lauren Gumbiner, MSW, LCSW
• Andres Gutierrez, MD

• Internal Medicine Physician in Winnetka, IL
• Providers in Winnetka, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.