Active NPI
Richard Dale Hubbell
- Otolaryngology Physician
- Maywood, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 036160130
- Practice address
- 2160 S 1St Ave
Maywood, IL 60153-3328 - Phone
- (708) 216-9000
- NPI assigned
- Mar 28, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 267550 | MA | |
| Pediatric Otolaryngology Physician | 207YP0228X | R-12193 | IA | |
| Pediatric Otolaryngology Physician | 207YP0228X | 036160130 | IL | |
| Otolaryngology Physician | 207Y00000X | 036160130 | IL | Primary |
Addresses
Primary practice location
2160 S 1St Ave
Maywood, IL 60153-3328
Mailing address
200 Hawkins Dr
Iowa City, IA 52242-1009
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | RHUBBELL49079@DIRECT.LUHS.ORG | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-12193 | IA | MD | Pediatric Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loyola University Medical Center | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients |
Locations
6800 N Frontage Rd
Burr Ridge, IL 60527
Phone (708) 327-1000
500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119
2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400
1S260 Summit Ave
Oakbrook Terrace, IL 60181
Phone (630) 953-6600
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.
-
- General Practice Physician
- Maywood, IL
- NPI 1336159961
-
- Community/Retail Pharmacy
- Maywood, IL
- NPI 1184789299
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Melrose Park, IL
- NPI 1831170232
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
- General Acute Care Hospital
- Tinley Park, IL
- NPI 1427752013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663891200000",
"number": "1295197242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBELL",
"first_name": "RICHARD",
"middle_name": "DALE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-28",
"last_updated": "2022-09-23",
"certification_date": "2022-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MA",
"license": "267550",
"primary": false
},
{
"code": "207YP0228X",
"taxonomy_group": "",
"desc": "Otolaryngology, Pediatric Otolaryngology",
"state": "IA",
"license": "R-12193",
"primary": false
},
{
"code": "207YP0228X",
"taxonomy_group": "",
"desc": "Otolaryngology, Pediatric Otolaryngology",
"state": "IL",
"license": "036160130",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IL",
"license": "036160130",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "RHUBBELL49079@DIRECT.LUHS.ORG",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2160 S 1st Ave",
"city": "Maywood",
"state": "IL",
"country_code": "US",
"postal_code": "601533328",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.