Individual provider Active NPI

Reginald Lafate Spears, M.D.

  • Internal Medicine Physician
  • Long Grove, IL
National Provider Identifier
1861485153
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-091992 Issued in IL
Practice address
4160 Route 83
Suite 207
Long Grove, IL 60047
Phone
(847) 415-2127
NPI assigned
Aug 23, 2005
Reactivated
Apr 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-091992 IL Primary

Addresses

Primary practice location

4160 Route 83
Suite 207
Long Grove, IL 60047

Mailing address

4160 Route 83
Suite 207
Long Grove, IL 60047
Phone (847) 415-2127

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
I20031209000504 IL Practitioner - Internal Medicine 3072417989

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Southern Illinois University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4160 Il Route 83 207
Long Grove, IL 60047-8034

4160 Route 83 207
Long Grove, IL 60047-8034

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-091992ILMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: rspears236424@direct.myadvocateaurora.org

Hospital & facility affiliations 8

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260316800000",
    "number": "1861485153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 ROUTE 83",
            "address_2": "SUITE 207",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "60047",
            "telephone_number": "847-415-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 ROUTE 83",
            "address_2": "SUITE 207",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "60047",
            "telephone_number": "847-415-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEARS",
        "first_name": "REGINALD",
        "middle_name": "LAFATE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2009-12-09",
        "deactivation_date": "2006-03-27",
        "reactivation_date": "2006-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-091992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Grove, IL

Sources for this page

Verify at the official NPI Registry.