GENESIS ORTHOPEDICS & SPORTS MEDICINE LLC – Orthopaedic Surgery Physician, NPI 1346389061
Orthopaedic Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for GENESIS ORTHOPEDICS & SPORTS MEDICINE LLC
2425 W 22nd St Ste 212
Oak Brook, IL 605234658
Phone: (630) 377-1188
Fax: (630) 377-7360
Type: Location
200 S Greenleaf St Ste A
Gurnee, IL 600313398
Phone: (630) 377-1188
Fax: (630) 377-7360
Type: Location
2825 Foxfield Rd Ste 200
St Charles, IL 601745734
Phone: (630) 377-1188
Fax: (630) 377-7360
Type: Location
645 S Central Ave
Chicago, IL 606445059
Phone: (630) 377-1188
Fax: (630) 377-7360
Type: Location
2641 W Harrison St
Chicago, IL 606123420
Phone: (630) 377-1188
Fax: (630) 377-7360
Type: Location
4709 Golf Rd Ste 1220
Skokie, IL 600761231
Phone: (630) 377-1188
Fax: (630) 377-7360
Type: Location
1044 N Francisco Ave Ste 405
Chicago, IL 606222743
Phone: (630) 377-1188
Fax: (630) 377-7360
Type: Location
4111 W 26th St Ste 200
Chicago, IL 606234992
Phone: (630) 377-1188
Fax: (630) 377-7360
Type: Location
1 Erie Ct Ste 7050
Oak Park, IL 603022510
Phone: (630) 377-1188
Fax: (630) 377-7360
Type: Location
1125 Westgate St
Oak Park, IL 603011007
Phone: (630) 377-1188
Fax: (630) 377-7360
Type: Location
1315 N Highland Ave Ste 201
Aurora, IL 605061460
Phone: (630) 377-1188
Fax: (630) 377-7360
Type: Location
2900 FOXFIELD RD
SUITE 102
ST CHARLES, IL 601745799
Phone: (630) 377-1188
Fax: (630) 377-7360
Type: Mailing
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: 2010-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-10-31 (589 days ago).
Enrollment records
2
Earliest due date
2024-10-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040713001038 | O | Clinic/Group Practice | IL | 2024-10-31 |
| O20100930016182 | O | Physician - Orthopedic/Orthopedic Surgery | IL | 2026-10-31 |
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.
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 60523)
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