James A Runke, M.D. – Internal Medicine Physician

Key facts

NPI: 1952425035
Entity type: Individual (NPI type 1)
Primary specialty: Internal Medicine Physician 207R00000X
License: 36-072041 (IL)
Practice address: 180 N Michigan Ave
Suite 1605
Chicago, IL 60601-7478
Phone: (312) 201-1234
Fax: (312) 201-1202
NPI assigned: Mar 16, 2007
Sex: Male
Sole proprietor: Yes

Organizations & group practices 3

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.

Michigan Avenue Immediate Care Family Medicine Physician · Chicago, IL · NPI 1174658694

Medicare reassignment Care Compare group NPD Authorized official IL
Michigan Avenue Primary Care, S.C. Family Medicine Physician · Chicago, IL · NPI 1013239672

Medicare reassignment NPD Authorized official IL · INTERNAL MEDICINE
Michigan Avenue ENT P.C. Otolaryngology Physician · Chicago, IL · NPI 1043735483

NPD Authorized official

Medicare Care Compare profile

Specialty: Internal Medicine
Education: University of Wisconsin School of Medicine, 1984
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Michigan Avenue Immediate Care (4 clinicians)

Practice addresses (Care Compare)

180 N Michigan Ave
Suite 1605
Chicago, IL 60601-7478
Phone (312) 201-1234

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
I20091030000043	IL	Practitioner - Internal Medicine	6800933441	Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD): No
HHS exclusion list flag: The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
36-072041	IL	MD	Internal Medicine Physician

Practice roles

Organization	Specialty	Status	New patients
Michigan Avenue ENT P.C.		Current since Jan 26, 2019	Accepting new patients
Michigan Avenue Immediate Care		Current since Oct 30, 2009	Accepting new patients
Michigan Avenue Primary Care, S.C.	Internal Medicine	Current since Dec 1, 2012	Accepting new patients

Locations

180 N Michigan Ave
Ste 1607
Chicago, IL 60601

180 N Michigan Ave
Ste 1605
Chicago, IL 60601
Phone (312) 201-1234

180 N Michigan Ave
Ste 1720
Chicago, IL 60601
Phone (312) 994-3000

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician	207R00000X	36-072041	IL	Yes

Addresses

Primary practice location

180 N Michigan Ave
Suite 1605
Chicago, IL 60601-7478

Mailing address

180 N Michigan Ave
Suite 1605
Chicago, IL 60601-7478
Phone (312) 201-1234

Other identifiers

Identifier	Type	State	Issuer
036072	Medicaid	IL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 12, 2012.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1952425035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE",
            "address_2": "SUITE 1605",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017478",
            "telephone_number": "312-201-1234",
            "fax_number": "312-201-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE",
            "address_2": "SUITE 1605",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017478",
            "telephone_number": "312-201-1234",
            "fax_number": "312-201-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNKE",
        "first_name": "JAMES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36-072041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036072",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

All providers in Chicago, IL · Internal Medicine Physician in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2012. 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.