Individual provider Active NPI

Matthew Scott Hanlon, D.O.

  • Family Medicine Physician
  • Oak Lawn, IL
National Provider Identifier
1104937622
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-098805 Issued in IL
Practice address
4061 W 95TH St Ste 3
Oak Lawn, IL 60453-2611
Phone
(708) 423-2880
Fax
(708) 423-2933
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-098805 IL Primary

Addresses

Primary practice location

4061 W 95TH St Ste 3
Oak Lawn, IL 60453-2611

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-2000

Other identifiers 2

IdentifierTypeStateIssuer
01621926OtherILBLUE CROSS BLUE SHIELD
080139777OtherILRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mhanlon189858@dulyhealthandcare.direct-ci.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100903000822 IL Practitioner - Family Practice 9830213362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mid West Medical College, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone (708) 226-7000

2100 Glenwood Ave
Joliet, IL 60435-5487
Phone (815) 725-2121

30 Stratford Dr
Bloomingdale, IL 60108-2201
Phone (630) 893-2210

40 S Clay St
Hinsdale, IL 60521-3257

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone (630) 469-9200

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

Hospital & facility affiliations

  • Osf Home Health Home health agency, Oak Lawn, IL, CCN 147404
  • Interim Healthcare of Chicago Home health agency, Alsip, IL, CCN 147182
  • Palos Community Hospital Home Health Care Home health agency, Lemont, IL, CCN 147470
  • Advocate Home Health Care Serv Home health agency, Oakbrook, IL, CCN 147150
  • Osf Little Company of Mary Medical Center Hospital, Evergreen Park, IL, CCN 140179
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Smith Village Nursing home, Chicago, IL, CCN 145904

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Mar 11, 2019 Accepting new patients
Dupage Medical Group LTD CurrentSince Mar 11, 2019 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

2850 W 95th St
Ste 403
Evergreen Pk, IL 60805
Phone (708) 423-2662

4061 W 95th St
Oak Lawn, IL 60453
Phone (630) 432-6200

4061 W 95th St
Ste 3
Oak Lawn, IL 60453
Phone (708) 423-2880

Interoperability endpoints

  • Direct secure messaging: mhanlon189858@dulyhealthandcare.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1104937622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 W 95TH ST STE 3",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532611",
            "telephone_number": "708-423-2880",
            "fax_number": "708-423-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLON",
        "first_name": "MATTHEW",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-098805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01621926",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080139777",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhanlon189858@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "1860 Paysphere Cir",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606742735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.