NPIMap

Organization Active NPI

Infectious Diseases Associates, P.C.

  • Infectious Disease Physician
  • Elk Grove Village, IL
National Provider Identifier
1790774016
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
060-004299 Issued in IL
Legal business name
INFECTIOUS DISEASES ASSOCIATES, P.C.
Practice address
800 Biesterfield Rd
Brock 4011
Elk Grove Village, IL 60007-3361
Phone
(847) 981-3694
Fax
(847) 981-6508
NPI assigned
Oct 19, 2005
Last updated
Jun 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Authorized official

Name
Lynwood A Jones III, M.D.NPI 1922097195
Title
Vice President
Phone
(847) 981-3694

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X 060-004299 IL Primary

Addresses

Primary practice location

800 Biesterfield Rd
Brock 4011
Elk Grove Village, IL 60007-3361

Mailing address

800 Biesterfield Rd
Brock 4011
Elk Grove Village, IL 60007-3361
Phone (847) 981-3694

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040930001049 IL Part B Supplier - Clinic/Group Practice 1456320944 Receives reassigned benefits from 7 practitioners
Practice locations: Elk Grove VLG, IL

National Provider Directory

National Provider Directory

Locations

810 Biesterfield Rd
Ste 308
Elk Grove Vlg, IL 60007
Phone (847) 382-9902

850 Biesterfield Rd
Ste 3003
Elk Grove Vlg, IL 60007
Phone (847) 981-3694

850 Biesterfield Rd
Ste 4011
Elk Grove Vlg, IL 60007
Phone (847) 981-3694

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277251200000",
    "number": "1790774016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "BROCK 4011",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-981-3694",
            "fax_number": "847-981-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "BROCK 4011",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-981-3694",
            "fax_number": "847-981-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASES ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2010-06-23",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "LYNWOOD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "847-981-3694",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "060-004299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.