Elk Grove Medical Associates, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ELK GROVE MEDICAL ASSOCIATES, LLC

Practice address

800 Biesterfield Rd Ste 625
Elk Grove Village, IL 60007-3362

Phone

(847) 981-6061

Fax

(872) 241-0118

NPI assigned

Apr 15, 2008

Last updated

Mar 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Barry Michael Glick, DONPI 1013903509

Title

President

Phone

(312) 505-1845

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Barry Glick, DO

  • Internal Medicine Physician
  • Elk Grove Village, IL
  • NPI 1013903509
  Authorized official Same address or phone
• Diane Juglal-Toczek, AGNP

  • Nurse Practitioner
  • Elk Grove Village, IL
  • NPI 1245809086
  NPD

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1770757304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD STE 625",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073362",
            "telephone_number": "847-981-6061",
            "fax_number": "872-241-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD STE 625",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073362",
            "telephone_number": "847-981-6061",
            "fax_number": "872-241-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK GROVE MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A",
        "authorized_official_last_name": "GLICK",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-505-1845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elk Grove SLF, LLC

• Internal Medicine Physician in Elk Grove Village, IL
• Providers in Elk Grove Village, 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 Mar 22, 2024; 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.