Individual provider Active NPI

Jonathan L Berry, DO

  • Hospitalist Physician
  • Palos Heights, IL
National Provider Identifier
1942705587
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036157777 Issued in PA
Practice address
12251 S 80TH Ave
Palos Heights, IL 60463-1290
Phone
(708) 923-4000
Fax
(708) 923-5859
NPI assigned
Mar 26, 2018
Last updated
Nov 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.157777 IL
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 036157777 PA Primary

Addresses

Primary practice location

12251 S 80TH Ave
Palos Heights, IL 60463-1290

Mailing address

12251 S 80TH Ave
Palos Heights, IL 60463-1290
Phone (708) 923-4000

Other practice location 1

2800 W 95th St
Evergreen Park, IL 60805-2701
Phone (708) 422-6200

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
I20220124002460 IL Practitioner - HospitalistPractitioner - Internal Medicine 9739429622 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Middlesex University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

12251 S 80TH Ave
Palos Heights, IL 60463-1290
Phone (708) 923-5869

2800 W 95TH St
Evergreen, IL 60805-2701
Phone (708) 422-6200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.157777ILMDInternal Medicine Physician
036157777PAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Illinois, P.C. Internal Medicine CurrentSince Nov 4, 2021 Accepting new patients
Central Dupage Physician Group Internal Medicine CurrentSince Dec 1, 2024 Accepting new patients
Inpatient Consultants of Illinois, P.C. Internal Medicine Current Accepting new patients
Inpatient Consultants of Illinois, P.C. Internal Medicine CurrentSince Nov 4, 2021 Accepting new patients
Central Dupage Physician Group CurrentSince Dec 1, 2024 Accepting new patients

Locations

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2800 W 95th St
Evergreen Pk, IL 60805
Phone (708) 229-5104

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

12251 S 80th Ave
Palos Heights, IL 60463
Phone (708) 361-4500

12251 S 80th Ave
Ste 1780
Palos Heights, IL 60463
Phone (708) 923-3420

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1942705587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631290",
            "telephone_number": "708-923-4000",
            "fax_number": "708-923-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631290",
            "telephone_number": "708-923-4000",
            "fax_number": "708-923-5859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 W 95th St",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608052701",
            "country_code": "US",
            "telephone_number": "708-422-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JONATHAN",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.157777",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "036157777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.