Individual provider Active NPI

Terry Wayne Love, D.O.

  • Family Medicine Physician
  • Ottawa, IL
National Provider Identifier
1124034459
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036052926 Issued in IL
Practice address
645 W Main St
Ottawa, IL 61350-2717
Phone
(815) 434-1977
Fax
(815) 434-2022
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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 036052926 IL Primary

Addresses

Primary practice location

645 W Main St
Ottawa, IL 61350-2717

Mailing address

645 W Main St
Ottawa, IL 61350-2717
Phone (815) 434-1977

Other identifiers 2

IdentifierTypeStateIssuer
P01428101OtherILPALMETTO GBA
36052926MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Chicago College of Osteopathy, 1975
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

645 W Main St
Ottawa, IL 61350-2717

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Hospital & facility affiliations 3

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1124034459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 W MAIN ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613502717",
            "telephone_number": "815-434-1977",
            "fax_number": "815-434-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 W MAIN ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613502717",
            "telephone_number": "815-434-1977",
            "fax_number": "815-434-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVE",
        "first_name": "TERRY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036052926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "P01428101",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36052926",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, IL

Sources for this page

Verify at the official NPI Registry.