Individual provider Active NPI

Boris Gurevich, M.D.

  • Internal Medicine Physician
  • Northbrook, IL
National Provider Identifier
1902877129
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036062524 Issued in IL
Practice address
3400 Dundee Rd Ste 230
Northbrook, IL 60062-2334
Phone
(847) 849-1523
Fax
(847) 890-6145
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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 036062524 IL Primary

Addresses

Primary practice location

3400 Dundee Rd Ste 230
Northbrook, IL 60062-2334

Mailing address

566 Lincoln Ave Unit 2E
Winnetka, IL 60093-2354
Phone (847) 226-5503

Other identifiers 1

IdentifierTypeStateIssuer
036062524MedicaidIL

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
I20100119000650 IL Practitioner - Internal Medicine 1355245630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3400 Dundee Rd
Suite 230
Northbrook, IL 60062-2334
Phone (847) 849-1523

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bvgmedical PLLC Internal Medicine CurrentSince Jul 22, 2024 Accepting new patients
California Devon Medical Center Internal Medicine PastSince Jul 7, 1982 Accepting new patients

Locations

3400 Dundee Rd
Ste 230
Northbrook, IL 60062
Phone (847) 226-5503

3400 Dundee Rd
Northbrook, IL 60062
Phone (312) 492-4820

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bella Terra WheelingWheeling, IL, CCN 145835 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Sep 1, 2019
Sep 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1902877129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "566 LINCOLN AVE UNIT 2E",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600932354",
            "telephone_number": "847-226-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 DUNDEE RD STE 230",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622334",
            "telephone_number": "847-849-1523",
            "fax_number": "847-890-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUREVICH",
        "first_name": "BORIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036062524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036062524",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.