Provider Demographics
NPI:1679607485
Name:NERI, GREGORY GERMAN (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:GERMAN
Last Name:NERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2731 SHOWPLACE DR UNIT 302
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-3362
Mailing Address - Country:US
Mailing Address - Phone:312-623-0381
Mailing Address - Fax:
Practice Address - Street 1:2731 SHOWPLACE DR UNIT 302
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-3362
Practice Address - Country:US
Practice Address - Phone:312-623-0381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361187052085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036118705Medicaid
ILK41268Medicare PIN