Michael G Close, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036086466434341568 Issued in IL

Practice address

5137 N Broadway St
Chicago, IL 60640-3009

Phone

(773) 243-0010

Fax

(773) 243-0015

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Internal Medicine

Education

Saint Louis University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fullerton Kimball Medical Group SCGroup PAC ID 3476596610, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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.

• Fullerton Kimball Medical Group SC

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831213081
  Medicare reassignment Care Compare group NPD
• American Women'S Professional Group Corp

  • Obstetrics & Gynecology Physician
  • Chicago, IL
  • NPI 1104096031
  Medicare reassignment NPD
• Integrated Pain Management SC

  • Pain Medicine (Anesthesiology) Physician
  • Lombard, IL
  • NPI 1447290713
  Medicare reassignment NPD
• Hoscon, LTD

  • Nephrology Physician
  • Downers Grove, IL
  • NPI 1932487360
  NPD
• Integrated Pain Management SC

  • Non-Pharmacy Dispensing Site
  • Arlington Heights, IL
  • NPI 1639928096
  NPD
• LX Health Advocate Center LTD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1043223688
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1992893184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5137 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403009",
            "telephone_number": "773-243-0010",
            "fax_number": "773-243-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5137 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403009",
            "telephone_number": "773-243-0010",
            "fax_number": "773-243-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOSE",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036086466434341568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1622969",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086407",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01633171",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mona Clor, MD
• Christianne Clorina, MED
• Close Knit Therapy, LLC
• Emily Close, LCSW
• John Close, MSPT
• Closer Look Imaging LLC
• Jonathan Closner, LMHC, LCPC, LPC
• Meghan Closser
• Cloud Gate Acupuncture
• Cloud Nine Counseling PLLC

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, 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 Jun 5, 2014; 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.
• Medicare Care Compare (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.