Anthony James Geroulis, M.D.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

36.050050 Issued in IL

Practice address

330 West Frontage Rd.
Northfield, IL 60093

Phone

(847) 441-4441

Fax

(847) 784-9744

NPI assigned

Dec 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment NPD
• University of Chicago

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1821048786
  Medicare reassignment NPD
• The University of Chicago Medical Center

  • Community/Retail Pharmacy
  • Calumet City, IL
  • NPI 1255895678
  NPD

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1982769717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 WEST FRONTAGE RD.",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "60093",
            "telephone_number": "847-441-4441",
            "fax_number": "847-784-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 WEST FRONTAGE RD.",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "60093",
            "telephone_number": "847-441-4441",
            "fax_number": "847-784-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEROULIS",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "IL",
            "license": "036050050",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "IL",
            "license": "36.050050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036050050",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vanessa Galvan
• Faye Therese Gamboa, O.D.
• Sam Gao, LMT
• Bozena Garvey, MA
• Meredith Gentry
• William David Gieseke, PH.D.
• Fred Allen Gitles, M.S.W.
• Gretchen Witte Glader, L.C.S.W, PH.D
• Michael Jason Gladstein, ED.S.
• Krystal Glassman, LCPC

• Otolaryngology/Facial Plastic Surgery Physician in Northfield, IL
• Providers in Northfield, IL by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.