Judith Opena Disterhoft, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036.159212 Issued in IL

Practice address

3 Erie CT
Oak Park, IL 60302-2519

Phone

(708) 383-6200

NPI assigned

Jun 14, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Loyola University of Chicago, Stritch School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Near North Health Service CorporationGroup PAC ID 9638165749, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: judith.disterhoft.1@31131.direct.athenahealth.com
• Direct secure messaging: judith.disterhoft.1@18552.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Near North Health Service Corporation

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1821079088

  IL

  Medicare reassignment Care Compare group NPD
• Resilience Healthcare - Lakefront Medical Associates, LLC

  • General Practice Physician
  • Chicago, IL
  • NPI 1205301926

  IL

  Medicare reassignment NPD
• Near North Health Service Corporation

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1740166255
  Care Compare group NPD
• Near North Health Service Corporation

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1073594297
  Care Compare group
• Near North Health Service Corporation

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1346221553
  Care Compare group
• Near North Health Service Corporation

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1437312360
  Care Compare group
• Near North Health Service Corporation

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1659725133
  Care Compare group
• Near North Health Service Corporation

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1720404494
  Care Compare group
• Near North Health Service Corporation

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1922237890
  Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1093154809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ERIE CT",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022519",
            "telephone_number": "708-383-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ERIE CT",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022519",
            "telephone_number": "708-383-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTERHOFT",
        "first_name": "JUDITH",
        "middle_name": "OPENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.159212",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A143366",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Oak Park, IL
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.