Douglas A Henning, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-090769 Issued in IL

Practice address

1925 Huntley Rd
West Dundee, IL 60118-9301

Phone

(815) 338-6600

Fax

(847) 428-7425

NPI assigned

Nov 9, 2006

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

Other identifiers 3

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

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.

• Central Dupage Physician Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844

  Pediatrics

  NPD
• Central Dupage Physician Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1316017155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 HUNTLEY RD",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601189301",
            "telephone_number": "815-338-6600",
            "fax_number": "847-428-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 HUNTLEY RD",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601189301",
            "telephone_number": "815-338-6600",
            "fax_number": "847-428-7425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 E Congress Pkwy",
            "address_2": "STE M",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600390619",
            "country_code": "US",
            "telephone_number": "815-455-0850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNING",
        "first_name": "DOUGLAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-090769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCYCARE INSURANCE",
            "identifier": "HENNIDOU",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090769 2",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSWI",
            "identifier": "1316017155",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aimee Michelle Hafner
• Rabije Hajdini, LCPC
• Kaylei Halbert, RBT-17-38375
• Holly Audrey Hanson, PT, DPT
• Mark Hasselman, LCSW
• Aaron Henry
• Juan Hernandez
• Melany Hernandez
• Thomas Heroldt, MA,LCPC,CADC
• Herron Speech Therapy, PLLC

• Pediatrics Physician in West Dundee, IL
• Providers in West Dundee, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.