Erickson Health Medical Group of Illinois PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ERICKSON HEALTH MEDICAL GROUP OF ILLINOIS PC

Practice address

800 Audubon Way
Lincolnshire, IL 60069-3811

Phone

(847) 876-2200

Fax

(847) 793-0281

NPI assigned

Jul 21, 2006

Last updated

Aug 28, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Narrett, M.D.

Title

Executive VP, Cmo

Phone

(410) 402-2257

Specialties & licenses 9

Addresses

Other identifiers 1

Other names 1

• Sedgebrook Medical Center Other name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elliott Kroger, MD

  • Internal Medicine Physician
  • Waukegan, IL
  • NPI 1427087063
  NPD (past)
• Thomas Francis Morris, DO

  • Family Medicine Physician
  • Naples, FL
  • NPI 1326056045
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251417600000",
    "number": "1982624763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MAIDEN CHOICE LN",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212285968",
            "telephone_number": "410-402-2257",
            "fax_number": "410-402-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 AUDUBON WAY",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600693811",
            "telephone_number": "847-876-2200",
            "fax_number": "847-793-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICKSON HEALTH MEDICAL GROUP OF ILLINOIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2009-08-28",
        "status": "A",
        "authorized_official_last_name": "NARRETT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "EXECUTIVE VP, CMO",
        "authorized_official_telephone_number": "410-402-2257",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "4932996",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sedgebrook Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John Doughty
• Cathy Drucker, LCSW
• Staci Wynn Ducker, OD
• Educerus Health LLC
• Carey Eugene Ellis, MD
• Erickson Health Medical Group of Illinois, PC
• Elizabeth Ervick
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• Nikkie Evans
• Evenflo Company Inc

• Internal Medicine Physician in Lincolnshire, IL
• Providers in Lincolnshire, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.