Mark R. Ottolin, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036-064112 Issued in IL

Practice address

100 Spalding Drive
Suite 212
Naperville, IL 60504-6552

Phone

(630) 357-4111

Fax

(630) 357-4644

NPI assigned

Oct 2, 2006

Last updated

Sep 24, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhirprd.edward.org/fhirprd/api/FHIR/R4/

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.

• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Medicare reassignment NPD
• Dupage Medical Group LTD

  dba DuPage Medical Group

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  Medicare reassignment NPD
• Edward Hospital

  • General Acute Care Hospital
  • Naperville, IL
  • NPI 1013969013
  Medicare reassignment NPD
• Elmhurst Memorial Hospital

  dba Endeavor Health Elmhurst Hospital

  • General Acute Care Hospital
  • Elmhurst, IL
  • NPI 1548306343
  Medicare reassignment
• Naperville Psychiatric Ventures

  dba Linden Oaks Hospital

  • Psychiatric Hospital
  • Naperville, IL
  • NPI 1871628362
  Medicare reassignment
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  NPD
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD
• Edward Hospital

  • Home Health Agency
  • Naperville, IL
  • NPI 1912930645

  Cardiovascular Disease

  NPD
• Winfield Pathology Consultants, S.C.

  • Anatomic Pathology Physician
  • Winfield, IL
  • NPI 1528147071
  NPD
• Edward Cardiovascular Institute

  • Cardiovascular Disease Physician
  • Naperville, IL
  • NPI 1649386400
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1265525729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740018",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SPALDING DRIVE",
            "address_2": "SUITE 212",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605046552",
            "telephone_number": "630-357-4111",
            "fax_number": "630-357-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTOLIN",
        "first_name": "MARK",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-064112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mottolin37652@direct.edward.org",
            "affiliation": "N",
            "address_1": "100 Spalding Drive",
            "address_2": "Suite 212",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605046552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Otte Practice PLLC
• Otte Practice PLLC (Ellie Mental Health - Naperville)
• Otte Therapy LLC (Just Breathe Mental Health)
• Jennifer Otto, LPC
• Kimberly M Otto, APN
• Domenica D. Ottolino
• Our Children's Homestead
• Our Children's Homestead
• Our Childrens Homestead
• Basma Outhman, LSW

• Cardiovascular Disease Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.