Basic Information
Provider Information
NPI: 1225121528
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALPERT
FirstName: JOSHUA
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2350 ROYAL BLVD
Address2: SUITE 200
City: ELGIN
State: IL
PostalCode: 601234719
CountryCode: US
TelephoneNumber: 8479315300
FaxNumber: 8479319072
Practice Location
Address1: 2350 ROYAL BLVD
Address2: SUITE 200
City: ELGIN
State: IL
PostalCode: 601234719
CountryCode: US
TelephoneNumber: 8479315300
FaxNumber: 8479319072
Other Information
ProviderEnumerationDate: 10/02/2006
LastUpdateDate: 12/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XX0005X125-044075ILN Allopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
207X00000X036120195ILY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

ID Information
IDTypeStateIssuerDescription
20790601 MEDICARE GROUP MCHENRY COUNTYOTHER
03612019505IL MEDICAID
CE600101 RAILROAD MEDICARE GRP# KANE COUNTYOTHER
451517601 BCBSOTHER
20882101 MEDICARE GROUP KANE COUNTYOTHER
CG263101 RAILROAD MEDICARE MCHENRY CTYOTHER


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