Charles Scott Dehaan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-064615 Issued in IL

Practice address

124 N Water St
208
Rockford, IL 61107-3960

Phone

(815) 312-5810

Fax

(815) 312-5811

NPI assigned

Nov 14, 2006

Last updated

Dec 2, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Housecall Physicians Group of Rockford S C

  • Family Medicine Physician
  • Rockford, IL
  • NPI 1619900040
  NPD (past) Authorized official
• MD @ Home Illinois, SC

  dba Housecall Physicians of Illinois, SC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1568758415
  NPD (past)
• United Medical Group, SC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1427244029
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1144392499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 N WATER ST",
            "address_2": "208",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073960",
            "telephone_number": "815-312-5810",
            "fax_number": "815-312-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 N WATER ST",
            "address_2": "208",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073960",
            "telephone_number": "815-312-5810",
            "fax_number": "815-312-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAAN",
        "first_name": "CHARLES",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-064615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Ann Dee, PHARMD
• Janelle D Defilippis, APN
• Michael David Degould, DDS
• John J Deguide, M.D.
• Susan J Deguide, M.D.
• Misty Lynn Dehaven, APN
• George W. Dehoff III, MD
• Dekalb Eye Consultants, LLC (Rockford Retina Clinic)
• Ralph Dela Cruz
• Marconi Delegero Deladisma, MD

• Family Medicine Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.