Individual provider Active NPI

Jessica Carrie Dingman McIntyre, M.D.

  • Family Medicine Physician
  • Maywood, IL
National Provider Identifier
1164680518
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.120322 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000
NPI assigned
Jun 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD036380 DC
Family Medicine Physician 207Q00000X 036.120322 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Maywood, IL 60153-3328

Other names 1

  • Jessica Carrie Dingman Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmcintyre54429@direct.luhs.org Direct

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
I20110217000379 IL Practitioner - Family Practice 3577744051

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD036380DCMDFamily Medicine Physician
036.120322ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Jul 1, 2013 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Loyola University Medical Center CurrentSince Jul 1, 2013 Accepting new patients
Advanced Rehabilitation Clinics, Inc Past Accepting new patients

Locations

7255 W Grand Ave
Elmwood Park, IL 60707
Phone (708) 452-5809

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

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.

Hospital & facility affiliations 4

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": "1212278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1164680518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "JESSICA",
        "middle_name": "CARRIE DINGMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-01",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD036380",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.120322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmcintyre54429@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DINGMAN",
            "middle_name": "CARRIE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.