NPIMap

Organization Active NPI

Illinois Bone and Joint Institute, LLC

  • Pain Medicine Physician
  • Gurnee, IL
National Provider Identifier
1982400107
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
ILLINOIS BONE AND JOINT INSTITUTE, LLC
Practice address
202 S Greenleaf St Ste 202-F
Gurnee, IL 60031-3399
Phone
(847) 336-3335
Fax
(847) 336-3249
NPI assigned
Feb 19, 2025
Last updated
Oct 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Authorized official

Name
Raquel Leon
Title
Credentialing Manager
Phone
(847) 324-3976

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X NU Primary

Addresses

Primary practice location

202 S Greenleaf St Ste 202-F
Gurnee, IL 60031-3399

Mailing address

250 S Northwest Hwy Ste 200
Park Ridge, IL 60068-4252
Phone (847) 324-3976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250521000321 IL DME Supplier - Physician - General Practice 6002814878 Practice locations: Gurnee, IL

National Provider Directory

National Provider Directory
Tax ID family
Il Bone Joint Institute LLC83 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1982400107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S NORTHWEST HWY STE 200",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684252",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S GREENLEAF ST STE 202-F",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313399",
            "telephone_number": "847-336-3335",
            "fax_number": "847-336-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS BONE AND JOINT INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-19",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A",
        "authorized_official_last_name": "LEON",
        "authorized_official_first_name": "RAQUEL",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "847-324-3976"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.