NPIMap

Individual provider Active NPI

Gerald Simon, MD

  • Internal Medicine Physician
  • Countryside, IL
National Provider Identifier
1861450330
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036066840 Issued in IL
Practice address
6438 Joliet Rd Ste 203
Countryside, IL 60525-4624
Phone
(708) 352-5222
Fax
(708) 352-1576
NPI assigned
May 3, 2006
Last updated
Feb 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036066840 IL Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 36066840 IL

Addresses

Primary practice location

6438 Joliet Rd Ste 203
Countryside, IL 60525-4624

Mailing address

120 W 22ND St Ste 200
Oak Brook, IL 60523-1563
Phone (630) 573-5000

Other practice location 1

412 63rd St
Ste 100
Downers Grove, IL 60516-2000
Phone (630) 719-5470

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address gsimon250845@direct.myadvocateaurora.org Direct
Direct Messaging Address credentialing@nephdocs.com Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20050113000331 IL Practitioner - Internal Medicine 4688651334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1982
Medicare assignment
May accept Medicare assignment
Group practices
Nani Internal Med LLCGroup PAC ID 6901141498, 5 clinicians

Practice addresses (Care Compare)

412 63Rd St
Suite 100
Downers Grove, IL 60516-2000
Phone (331) 775-2783

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036066840ILMDInternal Medicine Physician
36066840ILMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Northern Illinois, LTD. CurrentSince Jul 16, 2019 Accepting new patients
Nephrology Associates of Northern Illinois, LTD. CurrentSince Jul 16, 2019 Accepting new patients
Nani Internal Med Aco, LLC Internal Medicine CurrentSince Dec 22, 2024 Accepting new patients
Nani Internal Med LLC Internal Medicine CurrentSince Dec 1, 2018 Accepting new patients
University of Chicago Past Accepting new patients

Locations

6438 Joliet Rd
Countryside, IL 60525
Phone (708) 352-5222

6438 Joliet Rd
Ste 203
Countryside, IL 60525
Phone (708) 352-5222

412 63rd St
Ste 100
Downers Grove, IL 60516
Phone (331) 775-2783

5101 Willow Springs Rd
Lagrange Hlds, IL 60525
Phone (708) 245-4073

120 Spalding Dr
Ste 410
Naperville, IL 60540
Phone (630) 369-0780

120 W 22nd St
Oak Brook, IL 60523

120 W 22nd St
Ste 200
Oak Brook, IL 60523
Phone (630) 575-5000

Interoperability endpoints

  • Direct secure messaging: gerald.simon.1@18778.direct.athenahealth.com
  • Direct secure messaging: gsimon250845@direct.myadvocateaurora.org
  • FHIR API: https://api.platform.athenahealth.com/18778/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1861450330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-573-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6438 JOLIET RD STE 203",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605254624",
            "telephone_number": "708-352-5222",
            "fax_number": "708-352-1576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 63rd St",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605162000",
            "country_code": "US",
            "telephone_number": "630-719-5470",
            "fax_number": "630-719-1923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "GERALD",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036066840",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "36066840",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gsimon250845@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6438 Joliet Rd Ste 203",
            "city": "Countryside",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605254624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 W 22nd St Ste 200",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6438 Joliet Rd Ste 203",
            "city": "Countryside",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605254624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Countryside, IL

Sources for this page

Verify at the official NPI Registry.