NPIMap

Organization Active NPI

Rush Oak Park Physicians Group Lake Street

  • Internal Medicine Physician
  • Oak Park, IL
National Provider Identifier
1841531456
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RUSH OAK PARK PHYSICIANS GROUP LAKE STREET
Practice address
1011 Lake St
Suite 300
Oak Park, IL 60301-1148
Phone
(708) 628-0600
NPI assigned
Mar 6, 2013
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
RUSH MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Scott A Halper
Title
Authorized Official
Phone
(312) 942-7770

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Pediatrics Physician 208000000X

Addresses

Primary practice location

1011 Lake St
Suite 300
Oak Park, IL 60301-1148

Mailing address

1011 Lake St
Suite 300
Oak Park, IL 60301-1148
Phone (708) 628-0600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130801000660 IL Part B Supplier - Clinic/Group Practice 3678714771 Receives reassigned benefits from 7 practitioners
Practice locations: Oak Park, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2060213Rush Oak Park Physicians Group Lake Street1011 Lake St, Ste 300, Oak Park, IL 60301Certificate of waiverJun 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Rush Oak Park Physicians Group Lake STR2 organizations share this tax ID, including this one
Part of
Rush Medical Group

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

75 Remittance Dr
Dept 1620
Chicago, IL 60675

730 Waukegan Rd
Deerfield, IL 60015

730 Waukegan Rd
Ste 100
Deerfield, IL 60015

1011 Lake St
Ste 300
Oak Park, IL 60301
Phone (708) 366-7896

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1841531456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 LAKE ST",
            "address_2": "SUITE 300",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011148",
            "telephone_number": "708-628-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 LAKE ST",
            "address_2": "SUITE 300",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011148",
            "telephone_number": "708-628-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSH OAK PARK PHYSICIANS GROUP LAKE STREET",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RUSH MEDICAL GROUP",
        "enumeration_date": "2013-03-06",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "HALPER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "312-942-7770"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.