NPIMap

Individual provider Active NPI

Joe Eggebeen, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Evergreen Park, IL
National Provider Identifier
1821071374
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
036061271 Issued in IL
Practice address
2800 W 95TH St
Evergreen Park, IL 60805-2746
Phone
(708) 422-4221
Fax
(708) 422-4415
NPI assigned
Nov 29, 2005
Last updated
Aug 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 036061271 IL Primary

Addresses

Primary practice location

2800 W 95TH St
Evergreen Park, IL 60805-2746

Mailing address

1509 Royal Oak Rd
Darien, IL 60561-8423
Phone (708) 422-4221

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
I20050207000594 IL Practitioner - Emergency Medicine 1658322789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Michigan Medical School, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians
Great Lakes Emergency Physicians Medical Group SCGroup PAC ID 8527493105, 15 clinicians

Practice addresses (Care Compare)

1500 S Fairfield Ave
Chicago, IL 60608-1782
Phone (773) 542-2000

7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone (773) 947-7500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036061271ILMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP CurrentSince Sep 10, 2017 Accepting new patients
Jackson Park Hospital Foundation Current Accepting new patients
Great Lakes Emergency Physicians Medical Group SC CurrentSince Dec 2, 2019 Accepting new patients
Cepamerica Illinois LLP CurrentSince Sep 10, 2017 Accepting new patients
Cepamerica Illinois LLP Current Accepting new patients
Unimed, LTD Past Accepting new patients
Emergency Care Physician Services Past Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1500 S Fairfield Ave
Chicago, IL 60608
Phone (773) 257-5701

2701 W 68th St
Chicago, IL 60629
Phone (773) 471-8000

7531 S Stony Island Ave
Chicago, IL 60649
Phone (773) 947-7310

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

1225 W Lake St
Melrose Park, IL 60160
Phone (708) 681-3000

8 Oak Park Dr
Bedford, MA 01730
Phone (781) 280-1527

Interoperability endpoints

  • Direct secure messaging: joeeggebeen@jph.medalliesdirect.net

Organizations & group practices 7

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 5

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1821071374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 ROYAL OAK RD",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605618423",
            "telephone_number": "708-422-4221",
            "fax_number": "708-422-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052746",
            "telephone_number": "708-422-4221",
            "fax_number": "708-422-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGGEBEEN",
        "first_name": "JOE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "036061271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.