John Croghan, M.D.
Individual provider Active NPI Internal Medicine Physician · Winnetka, IL
NPI 1790724060 · NPPES record last updated Feb 3, 2016
Key facts
- NPI
- 1790724060
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 036076821 (IL)
- Practice address
- 710 Oak St
Winnetka, IL 60093-2522 - Phone
- (847) 840-1470
- NPI assigned
- Jun 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Rush Medical College of Rush University, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Dedication Health LLC
Practice addresses (Care Compare)
710 Oak St
Winnetka, IL 60093-2522
Phone (847) 986-6770
Hospital & facility affiliations
- Access Life Care, LTD
- Northshore University Healthsystem - Evanston Hospital
- VI at the Glen
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050929000673 | IL | Practitioner - Internal Medicine | 7315840246 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036076821 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dedication Health LLC | Internal Medicine | Current |
Accepting new patients |
| Northshore Physicians Group, LLC | Past | Accepting new patients | |
| North Shore Physicians Group, LLC | Past | Accepting new patients | |
| North Shore Physicians Group, LLC | Past | Accepting new patients |
Locations
1625 Sheridan Rd
Ste A
Wilmette, IL 60091
Phone (847) 256-2890
710 Oak St
Winnetka, IL 60093
Phone (847) 840-1470
Interoperability endpoints
- https://api.platform.athenahealth.com/13127/brand/1/csg/1/fhir/r4
- john.croghan.1@13127.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036076821 | IL | Yes |
Addresses
Primary practice location
710 Oak St
Winnetka, IL 60093-2522
Mailing address
710 Oak St
Winnetka, IL 60093-2522
Phone (847) 986-6770
Other providers in Winnetka, IL
- Consulting & Clinical Psychology
- Continuum Care
- John Q. Cook
- Counseling Center of the North Shore, Inc.
- Colin Crawford
- Myles P Cunningham
- Michael A. Czarkowski
- Gregory A Dana
- Claudia Dancing
- Dangremond & Jaharis LLC
All providers in Winnetka, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.