Individual provider Active NPI

Phillip Dechristopher, MD PHD

  • Blood Banking & Transfusion Medicine Physician
  • Maywood, IL
National Provider Identifier
1245219344
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Blood Banking & Transfusion Medicine PhysicianTaxonomy code 207ZB0001X
License
36068429 Issued in IL
Practice address
2160 S First Ave
EMS BLDG., RM. 2209
Maywood, IL 60153
Phone
(708) 216-3250
Fax
(708) 216-2620
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine Physician 207ZB0001X 36068429 IL Primary

Addresses

Primary practice location

2160 S First Ave
EMS BLDG., RM. 2209
Maywood, IL 60153

Mailing address

2160 S First Ave
EMS BLDG., RM. 2209
Maywood, IL 60153
Phone (708) 216-3250

Other identifiers 2

IdentifierTypeStateIssuer
K16217OtherILMEDICARE
36068429MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pdechristopher15598@direct.luhs.org Other

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
I20050411000761 IL Practitioner - Pathology 1557308665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Loyola University of Chicago, Stritch School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

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, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Loyola University Medical Center CurrentSince Mar 17, 2023 Accepting new patients
Loyola University Medical Center CurrentSince Mar 17, 2023 Accepting new patients

Locations

420 W Butterfield Rd
Elmhurst, IL 60126
Phone (630) 832-2300

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

2160 S 1st Ave
Rm 2209
Maywood, IL 60153
Phone (708) 216-3250

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

2160 S 1st Ave
Bldg 101
Maywood, IL 60153
Phone (708) 216-8785

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

Organizations & group practices 3

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 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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1245219344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "address_2": "EMS BLDG., RM. 2209",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-3250",
            "fax_number": "708-216-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "address_2": "EMS BLDG., RM. 2209",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-3250",
            "fax_number": "708-216-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECHRISTOPHER",
        "first_name": "PHILLIP",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "IL",
            "license": "36068429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K16217",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36068429",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pdechristopher15598@direct.luhs.org",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2160 S First Ave",
            "address_2": "EMS BLDG., RM. 2209",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.