MD FAMILY MEDICAL PRACTICE LLC – Primary Care Clinic/Center, NPI 1285216242

MD FAMILY MEDICAL PRACTICE LLC is a healthcare provider. based in Northbrook, Illinois. specializing in Primary Care Clinic/Center. The NPI Number for MD FAMILY MEDICAL PRACTICE LLC is 1285216242

Main info

Organization
Name
MD FAMILY MEDICAL PRACTICE LLC
NPI
1285216242
Phone
(847) 975-6263
Address
47 BIRCHWOOD RD
Authorized Official
MARIA DERYLO DNP DNP
Enumeration Date
28 April 2021
Last Update Date
27 September 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness85
Years active:5State licenses:0Digital endpointsOther names

Provider Addresses for MD FAMILY MEDICAL PRACTICE LLC

  • 47 BIRCHWOOD RD

    NORTHBROOK, IL 600621244

    Phone: (847) 975-6263

    Fax: (888) 907-8030

    Type: Mailing

  • 5838 S Harlem Ave

    Summit, IL 605011407

    Phone: (847) 975-6263

    Fax: (888) 907-8030

    Type: Location

  • 1924 HIGHLAND AVE

    NORTHBROOK, IL 600625020

    Phone: (847) 975-6263

    Fax: (888) 907-8030

    Type: Mailing

  • 7425 W IRVING PARK RD

    CHICAGO, IL 606342139

    Phone: (847) 975-6263

    Fax: (888) 907-8030

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-05-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-05-31 (8 days ago).

Enrollment records

1

Earliest due date

2026-05-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20210519001956OClinic/Group PracticeIL2026-05-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60062)

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Reviews

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Frequently asked questions

What NPI should I save for MD FAMILY MEDICAL PRACTICE LLC?
Save NPI 1285216242 if you need a stable reference for MD FAMILY MEDICAL PRACTICE LLC.
Does this profile mean MD FAMILY MEDICAL PRACTICE LLC is currently active?
Yes — MD FAMILY MEDICAL PRACTICE LLC appears active in the national provider directory.
Does MD FAMILY MEDICAL PRACTICE LLC list a primary specialty?
If you are matching referrals, note Primary Care Clinic/Center for MD FAMILY MEDICAL PRACTICE LLC. Clinical services aligned with this taxonomy classification.
What location shows for MD FAMILY MEDICAL PRACTICE LLC?
We surface Northbrook, Illinois for MD FAMILY MEDICAL PRACTICE LLC based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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