One provider matched this enrollment ID.
Enrollment ID I20041005001237 resolves to a single NPI record. Open the full profile for complete detail.
Medicare enrollment
This provider holds 2 Medicare enrollments on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.
Practitioner
- I20041005001237Internal MedicineIA
- I20130408000447Internal MedicineIL
Source: CMS PECOS public enrollment file.
Secondary identifiers
Additional identifiers this provider has registered with NPPES. Used by medical billers, credentialers, and insurance verifiers to cross-reference claims and enrollments.
Other
- 421060724· Issued by TRICARE
- 336056024IL· Issued by CONTROLLED SUBSTANCE#
- 54808IA· Issued by IOWA BC/BS
- 421060724IA· Issued by BILLING TAX ID # FOR CHC
- 42106072461IA· Issued by JOHN DEERE HEALTH
- 8122859IL· Issued by ILLINOIS BC/BS
- 072992IA· Issued by HEALTH ALLIANCE #
- 1237527IA· Issued by CONTROLLED SUBSTANCE #
- IA0161IA· Issued by JOHN DEERE EDI#
Medicaid
Source: NPPES public registry.
ReferenceAbout Medicare Enrollment IDs
A Medicare Enrollment ID (ENRLMT_ID) is a 15-character public identifier assigned by the CMS Provider Enrollment, Chain and Ownership System (PECOS) when a provider, supplier, or organisation enrols in Medicare. Each row reflects one enrolment record: a single NPI can hold multiple enrolments across provider types, states, or supplier categories. Data here is mirrored from the quarterly public PECOS enrolment file published on data.cms.gov.