Individual provider Active NPI

Rebecca E Grauer, M.D.

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1871548230
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-110862 Issued in IL
Practice address
225 E Chicago Ave
Box #152
Chicago, IL 60611-2991
Phone
(312) 227-7413
Fax
(312) 227-9525
NPI assigned
May 24, 2006
Last updated
Jan 14, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-110862 IL Primary

Addresses

Primary practice location

225 E Chicago Ave
Box #152
Chicago, IL 60611-2991

Mailing address

225 East Chicago Ave.
Box #152
Chicago, IL 60611-2605
Phone (312) 227-7413

Other identifiers 2

IdentifierTypeStateIssuer
021622158OtherILCMMG BLUE SHIELD
1992758544OtherILCMMG NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-110862ILMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1871548230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 EAST CHICAGO AVE.",
            "address_2": "BOX #152",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112605",
            "telephone_number": "312-227-7413",
            "fax_number": "312-227-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "address_2": "BOX #152",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-7413",
            "fax_number": "312-227-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAUER",
        "first_name": "REBECCA",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-110862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMMG BLUE SHIELD",
            "identifier": "021622158",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMMG NPI",
            "identifier": "1992758544",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.