Individual provider Active NPI

Dillon Bannis, MD

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1124360425
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036.144095 Issued in IL
Practice address
2525 S Michigan Ave
Chicago, IL 60616-2315
Phone
(312) 567-2000
NPI assigned
Mar 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036.144095 IL Primary

Addresses

Primary practice location

2525 S Michigan Ave
Chicago, IL 60616-2315

Mailing address

50 Menores Ave
727
Coral Gables, FL 33134-4087

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
I20171025000000 IL Practitioner - Obstetrics/Gynecology 0143596825 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.144095ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Chicago, Inc. Obstetrics & Gynecology CurrentSince Sep 22, 2021 Accepting new patients
Insight Chicago, Inc. CurrentSince Sep 22, 2021 Accepting new patients
Access Community Health Network CurrentSince Jan 8, 2018 Accepting new patients
Access Community Health Network Current Accepting new patients

Locations

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

5159 S Ashland Ave
Chicago, IL 60609
Phone (773) 424-9216

600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505692800000",
    "number": "1124360425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MENORES AVE",
            "address_2": "727",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162315",
            "telephone_number": "312-567-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNIS",
        "first_name": "DILLON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2017-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036.144095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.