Individual provider Active NPI

Dawn Renee Phillips, M.D.

  • Ophthalmology Physician
  • Bolingbrook, IL
National Provider Identifier
1235293630
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036-106629 Issued in IL
Practice address
718 S Weber Road
Bolingbrook, IL 60490
Phone
(630) 378-4799
Fax
(630) 378-4783
NPI assigned
Dec 20, 2006
Last updated
Nov 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036-106629 IL Primary

Addresses

Primary practice location

718 S Weber Road
Bolingbrook, IL 60490

Mailing address

718 S Weber Road
Bolingbrook, IL 60490
Phone (630) 378-4799

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
I20050420000714 IL Practitioner - Ophthalmology 4688612666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryan J Phillips MD SCGroup PAC ID 8729026794, 2 clinicians

Practice addresses (Care Compare)

718 S Weber Rd
Bolingbrook, IL 60490-5472
Phone (630) 378-4799

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-106629ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan J Phillips MD SC Ophthalmology CurrentSince Jun 1, 2005 Accepting new patients

Locations

718 S Weber Rd
Bolingbrook, IL 60490
Phone (630) 378-4799

Organizations & group practices 1

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 1

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1235293630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 S WEBER ROAD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "60490",
            "telephone_number": "630-378-4799",
            "fax_number": "630-378-4783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 S WEBER ROAD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "60490",
            "telephone_number": "630-378-4799",
            "fax_number": "630-378-4783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "DAWN",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-106629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.