Healthcare Provider Details

I. General information

NPI: 1568417780
Provider Name (Legal Business Name): CLAUS J FIMMEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 SKOKIE BLVD. SUITE 110
NORTHBROOK IL
60062-1614
US

IV. Provider business mailing address

950 TECHNOLOGY WAY SUITE 250
LIBERTYVILLE IL
60048-5366
US

V. Phone/Fax

Practice location:
  • Phone: 224-407-4400
  • Fax: 224-407-2255
Mailing address:
  • Phone: 224-407-4400
  • Fax: 224-407-2255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number13614-320
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number036115700
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036115700
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: