1255888285 NPI number — MICHELLE GROCHOCINSKI

Table of content: DR. ELIZABETH ANN SCHAEFER MD (NPI 1174652382)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255888285 NPI number — MICHELLE GROCHOCINSKI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GROCHOCINSKI
Provider First Name:
MICHELLE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255888285
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/07/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10001 GRAND AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60131-2563
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-451-0330
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10001 GRAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN PARK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60131-2563
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-451-0330
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/07/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1030248 . This is a "ILLINICARE HEALTH PLAN MMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1030278 . This is a "HEALTHSPRING OF ILLINOIS MMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1020257 . This is a "MOLINA HEALTHCARE OF ILLINOIS ICP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1020577 . This is a "COMMUNITY CARE ALLIANCE IL ICP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1000264 . This is a "HEALTH ALLIANCE CONNECT FHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1020237 . This is a "AETNA BETTER HEALTH INC ICP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1020247 . This is a "ILLINICARE HEALTH PLAN INC ICP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1030198 . This is a "MERIDIAN HEALTH PLAN INC MMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1000194 . This is a "MERIDIAN HEALTH PLAN INC VMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1000565 . This is a "COUNTYCARE FHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1020567 . This is a "COUNTYCARE ICP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1030108 . This is a "HUMANA HEALTH PLAN INC MMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1030258 . This is a "MOLINA HEALTHCARE OF ILL MMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1030268 . This is a "HEALTH ALLIANCE CONNECT INC MMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1000154 . This is a "HARMONY HEALTH PLAN INC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1020107 . This is a "HUMANA HEALTH PLAN INC ICP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1020267 . This is a "HEALTH ALLIANCE CONNECT INC ICP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3000002 . This is a "DASA MCO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1020287 . This is a "BLUE CROSS BLUE SHIELD IPC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3000007 . This is a "DCFS MCO" identifier . This identifiers is of the category "OTHER".




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