Individual provider Active NPI

Diana Carol McNulty, MD

  • Internal Medicine Physician
  • Freeport, IL
National Provider Identifier
1215900105
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036103840 Issued in IL
Practice address
1010 Fairway Dr
Freeport, IL 61032-6600
Phone
(815) 599-7880
NPI assigned
Feb 10, 2006
Last updated
Jul 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036103840 IL Primary

Addresses

Primary practice location

1010 Fairway Dr
Freeport, IL 61032-6600

Mailing address

421 W Exchange St
Freeport, IL 61032-4008
Phone (815) 599-7950

Other practice location 1

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

Other identifiers 1

IdentifierTypeStateIssuer
036103840MedicaidIL

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
I20100205000081 IL Practitioner - Internal Medicine 2860535317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oregon Health Sciences University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1010 Fairway Dr
Freeport, IL 61032-6600
Phone (815) 599-7421

2600 Compass Rd
Glenview, IL 60026-8001

600 N Rush St
Stockton, IL 61085-1010
Phone (815) 947-3211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.84 of 100Reported as group
Quality
75.22
Promoting interoperability
92
Improvement activities
40
Cost
73.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Organizations & group practices 2

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.

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1215900105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 W EXCHANGE ST",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324008",
            "telephone_number": "815-599-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 FAIRWAY DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326600",
            "telephone_number": "815-599-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1045 W Stephenson St",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "IL",
            "postal_code": "610324864",
            "country_code": "US",
            "telephone_number": "815-599-6000",
            "fax_number": "815-599-7974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "DIANA",
        "middle_name": "CAROL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036103840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103840",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, IL

Sources for this page

Verify at the official NPI Registry.