Guy R Abderholden, MD
Individual provider
Active NPI
Family Medicine Physician · Antioch, IL
NPI 1902899792 · NPPES record last updated Dec 10, 2021
Key facts
- NPI
- 1902899792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036-084853 (IL)
- Practice address
- 543 Orchard St
Antioch, IL 60002-3107
- Phone
- (847) 395-3322
- Fax
- (847) 395-0921
- NPI assigned
- Aug 26, 2005
- Sex
- Male
- Sole proprietor
- No
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 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
Advocate Condell Medical Center Mobile Mammography Clinic/Center · Gurnee, IL · NPI 1023262441
-
Advocate Condell Medical Center General Acute Care Hospital · Libertyville, IL · NPI 1124272547
-
Advocate Condell Medical Center Mobile Mammography Clinic/Center · Grayslake, IL · NPI 1770737199
-
Ehs Home Health Care Service Inc Home Health Agency · Oak Brook, IL · NPI 1598732075
-
Northern Illinois Medical Center General Acute Care Hospital · McHenry, IL · NPI 1982611281
-
Northwestern Lake Forest Hospital General Acute Care Hospital · Lake Forest, IL · NPI 1124025176
-
Waukegan Hospice, LLC Community Based Hospice Care Agency · Gurnee, IL · NPI 1477505139
-
Waukegan Illinois Hospital Company LLC General Acute Care Hospital · Waukegan, IL · NPI 1639120694
-
Froedtert South, Inc. General Acute Care Hospital · Pleasant Prairie, WI · NPI 1003831132
Medicare Care Compare profile
- Specialty
- Family Practice
Also: General Practice - Education
- Loyola University of Chicago, Stritch School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Orchard Medical Center SC (4 clinicians)
Practice addresses (Care Compare)
543 Orchard St
Antioch, IL 60002-3107
Phone 8473953322111
Hospital & facility affiliations
- Advocate Home Health Care Serv Home health agency · Oakbrook, IL · CCN 147150
- Star Hospice Hospice · Gurnee, IL · CCN 141543
- Advocate Condell Medical Center Hospital · Libertyville, IL · CCN 140202
- Northwestern Lake Forest Hospital Hospital · Lake Forest, IL · CCN 140130
- Vista Medical Center East Hospital · Waukegan, IL · CCN 140084
- Northwestern Medicine McHenry Hospital · McHenry, IL · CCN 140116
- Froedtert South Inc. Hospital · Kenosha, WI · CCN 520021
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 12 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| I20100213000020 |
IL |
Practitioner - Family Practice
Practitioner - General Practice |
7012942592 |
Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|
| 036-084853 | IL | MD | Family Medicine Physician |
| 33453020 | WI | MD | Family Medicine Physician |
Practice roles
Interoperability endpoints
- Direct secure messaging: guyabderholden@orchardmed.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Family Medicine Physician |
207Q00000X |
33453020 |
WI |
|
| Family Medicine Physician |
207Q00000X |
036-084853 |
IL |
Yes |
Addresses
Primary practice location
543 Orchard St
Antioch, IL 60002-3107
Mailing address
543 Orchard St
Antioch, IL 60002-3107
Phone (847) 395-3322
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| 0360848531 | Medicaid | IL | |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|
| Direct Messaging Address |
guyabderholden@orchardmed.allscriptsdirect.net |
Direct |
|
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.
Verify at the official NPI Registry.