NPIMap

Individual provider Active NPI

Bela Glantsman, M.D.

  • Family Medicine Physician
  • Mundelein, IL
National Provider Identifier
1750347803
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-111232 Issued in IL
Practice address
333 E Il Route 83 Ste 105
Mundelein, IL 60060-4278
Phone
(847) 970-9922
Fax
(847) 970-9955
NPI assigned
Apr 25, 2006
Last updated
Mar 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-111232 IL Primary

Addresses

Primary practice location

333 E Il Route 83 Ste 105
Mundelein, IL 60060-4278

Mailing address

333 E Il Route 83 Ste 105
Mundelein, IL 60060-4278
Phone (847) 970-9922

Other identifiers 1

IdentifierTypeStateIssuer
036-111232OtherILLICENSE NO.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040831000602 IL Practitioner - Family Practice 8426023755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cordial Medical Center, S.C.Group PAC ID 6901898873, 3 clinicians

Practice addresses (Care Compare)

333 E Il Route 83
Suite 105
Mundelein, IL 60060-4278
Phone (847) 970-9922

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-111232ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cordial Medical Center, S.C. Family Medicine CurrentSince Jul 19, 2004 Accepting new patients
Advocate North Side Health Network Past Accepting new patients

Locations

1945 W Wilson Ave
Fl 4
Chicago, IL 60640
Phone (773) 736-6220

836 W Wellington Ave
Chicago, IL 60657
Phone (773) 296-7054

801 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-2900

333 E State Route 83
Ste 105
Mundelein, IL 60060
Phone (847) 970-9922

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.

Hospital & facility affiliations 11

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1750347803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E IL ROUTE 83 STE 105",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600604278",
            "telephone_number": "847-970-9922",
            "fax_number": "847-970-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E IL ROUTE 83 STE 105",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600604278",
            "telephone_number": "847-970-9922",
            "fax_number": "847-970-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLANTSMAN",
        "first_name": "BELA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-111232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NO.",
            "identifier": "036-111232",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mundelein, IL

Sources for this page

Verify at the official NPI Registry.