Individual provider Active NPI

John R Haebich, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1881647048
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036069235 Issued in IL
Practice address
3825 N Central Ave
Chicago, IL 60634-2719
Phone
(773) 282-6188
Fax
(773) 282-7389
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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 036069235 IL Primary

Addresses

Primary practice location

3825 N Central Ave
Chicago, IL 60634-2719

Mailing address

360 W Butterfield Rd Ste 325
Elmhurst, IL 60126-5088
Phone (773) 282-6188

Other identifiers 1

IdentifierTypeStateIssuer
036069235MedicaidIL

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
I20100817001210 IL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2567596281 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vip 2U, LTD. Internal Medicine CurrentSince Aug 23, 2018 Accepting new patients

Locations

360 W Butterfield Rd
Elmhurst, IL 60126
Phone (312) 833-0653

360 W Butterfield Rd
Ste 325
Elmhurst, IL 60126
Phone (312) 728-4728

600 Enterprise Dr
Ste 212
Oak Brook, IL 60523
Phone (312) 728-4728

Interoperability endpoints

  • Direct secure messaging: haebich.john.1@30821.direct.athenahealth.com

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1881647048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W BUTTERFIELD RD STE 325",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265088",
            "telephone_number": "773-282-6188",
            "fax_number": "773-282-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342719",
            "telephone_number": "773-282-6188",
            "fax_number": "773-282-7389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAEBICH",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036069235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036069235",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.