MEDICARE: NORTHWEST RHEUMATOLOGY SPECIALISTS, S.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	036053094	IL
2	207RR0500X	Rheumatology Physician	036078438	IL
3	332900000X	Non-Pharmacy Dispensing Site
4	207RR0500X	Rheumatology Physician	036085718	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073623872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST RHEUMATOLOGY SPECIALISTS, S.C.

Provider Business Mailing Address
First Line	:	800 BIESTERFIELD RD STE 4003
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3371
Country	:	US
Telephone Number	:	847-364-0800
Fax Number	:	847-364-0808

Provider Business Practice Location Address
First Line	:	800 W BIESTERFIELD RD
Second Line	:	STE 4003
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-7306
Country	:	US
Telephone Number	:	847-364-0800
Fax Number	:	847-364-0854

Authorized Official
Title or Position	:	PHYSICIAN PARTNER
Name	:	BRUCE JOHNSON
Credential	:	MD
Telephone Number	:	847-364-0800

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	02/15/2026

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