John Demask, D.O.
Individual provider Active NPI Family Medicine Physician · Minooka, IL
NPI 1174501134 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1174501134
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036094869 (IL)
- Practice address
- 201 S Wabena Ave
Minooka, IL 60447-8723 - Phone
- (815) 467-1518
- Fax
- (815) 467-7419
- NPI assigned
- Jan 9, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Chicago College of Osteopathy, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
24724 W Eames St
Channahon, IL 60410-5446
Phone (815) 467-5100
Hospital & facility affiliations
- At Home Quality Care - Morris
- Newsome Home Health Care & Purpose Care of Illinois - Joliet
- Morris Hospital & Healthcare Centers
- Saint Joseph Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040601000713 | IL | Practitioner - Family Practice | 2466433859 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Demask Family Medical S.C. | Current |
Accepting new patients | |
| Elite Gynecology S.C. | Past | Accepting new patients |
Locations
24724 W Eames St
Channahon, IL 60410
Phone (815) 467-5100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036094869 | IL | Yes |
Addresses
Primary practice location
201 S Wabena Ave
Minooka, IL 60447-8723
Mailing address
201 S Wabena Ave
Lower Level B
Minooka, IL 60447-8723
Phone (815) 941-9124
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036094869-1 | Medicaid | IL |
Other names
- Dr. Jack Demask
Other providers in Minooka, IL
- Jeffrey Clark
- Zachary Clark
- Cody Corradino
- Daryl L Condon,OD,PC
- Demask Family Medical S.C.
- Dental Professionals of Illinois, P.C.
- Dr M Estilo Pain Management LLC
- Lester Duldulao
- Roxanne Marie Dyers
- Lorisa Marie Eby
All providers in Minooka, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.