Individual provider Active NPI

Samuel N. Grief, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1821101007
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-101419 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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 036-101419 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

1919 W Taylor St
159 Hhdsb, MC 663
Chicago, IL 60612-7246
Phone (312) 413-4155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000627 IL Practitioner - Family Practice 3870627268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Care Center of Lake VillaGroup PAC ID 3870675572, 2 clinicians

Practice addresses (Care Compare)

213 S Milwaukee Ave
Lake Villa, IL 60046-8551
Phone (847) 356-9009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-101419ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Family Medicine CurrentSince Mar 1, 2000 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Mar 1, 2000 Accepting new patients
Medical Care Center of Lake Villa Family Medicine CurrentSince Mar 1, 2016 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients

Locations

722 W Maxwell St
#235
Chicago, IL 60607
Phone (312) 433-4114

1919 W Taylor St
#159
Chicago, IL 60612

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

213 S Milwaukee Ave
Lake Villa, IL 60046
Phone (847) 356-9009

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225929600000",
    "number": "1821101007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 W TAYLOR ST",
            "address_2": "159 HHDSB, MC 663",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127246",
            "telephone_number": "312-413-4155",
            "fax_number": "312-996-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIEF",
        "first_name": "SAMUEL",
        "middle_name": "N.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2008-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-101419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.