Individual provider Active NPI

Mark E Kaplan, MD

  • Allergy & Immunology Physician
  • Gurnee, IL
National Provider Identifier
1861591661
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
036077766 Issued in IL
Practice address
36100 N Brookside Dr Ste 203
Gurnee, IL 60031-4573
Phone
(847) 855-1570
Fax
(847) 855-1890
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 036077766 IL
Allergy & Immunology Physician 207K00000X 036077766 IL Primary

Addresses

Primary practice location

36100 N Brookside Dr Ste 203
Gurnee, IL 60031-4573

Mailing address

9800 Shelbyville Rd
Ste 220
Louisville, KY 40223-2992
Phone (502) 429-8585

Other practice location 1

1800 Hollister Dr Ste 210
Libertyville, IL 60048-5266
Phone (847) 549-7711

Other identifiers 3

IdentifierTypeStateIssuer
04900809OtherILBCBS PROVIDER ID
030004998OtherILRR MEDICARE PROVIDER ID
036077766 2MedicaidIL

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
I20120620000517 IL Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 6507020609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.25 of 100Reported as group
Quality
86.03
Promoting interoperability
86
Improvement activities
40
Cost
73.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036077766ILMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PSF PLLC Allergy & Immunology CurrentSince Oct 3, 2022 Accepting new patients

Locations

36100 N Brookside Dr
Ste 203
Gurnee, IL 60031
Phone (847) 775-1112

1800 Hollister Dr
Ste 210
Libertyville, IL 60048
Phone (847) 549-7711

9800 Shelbyville Rd
Ste 220
Louisville, KY 40223
Phone (502) 429-8585

Organizations & group practices 1

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1861591661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 SHELBYVILLE RD",
            "address_2": "STE 220",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232992",
            "telephone_number": "502-429-8585",
            "fax_number": "855-656-7325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36100 N BROOKSIDE DR STE 203",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600314573",
            "telephone_number": "847-855-1570",
            "fax_number": "847-855-1890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Hollister Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600485266",
            "country_code": "US",
            "telephone_number": "847-549-7711",
            "fax_number": "847-549-1020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAPLAN",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "IL",
            "license": "036077766",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "036077766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "04900809",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PROVIDER ID",
            "identifier": "030004998",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036077766 2",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

Verify at the official NPI Registry.