Gini Dutt, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

125053538 Issued in IL

Practice address

206 W Nippersink Rd
Round Lake, IL 60073-3511

Phone

(847) 546-8500

Fax

(847) 546-4409

NPI assigned

Aug 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4

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.

• Waukegan Clinic Corp

  • Family Medicine Physician
  • Waukegan, IL
  • NPI 1306937289

  Internal Medicine

  Medicare reassignment NPD
• Oncology Hematology Associates of Northern Illinois, LTD

  • Hematology & Oncology Physician
  • Gurnee, IL
  • NPI 1093142135
  NPD
• Min H. Lin, M.D. LTD.

  • Primary Care Clinic/Center
  • Round Lake, IL
  • NPI 1700071206
  NPD (past)

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1316137656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 W NIPPERSINK RD",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600733511",
            "telephone_number": "847-546-8500",
            "fax_number": "847-546-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W NIPPERSINK RD",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600733511",
            "telephone_number": "847-546-8500",
            "fax_number": "847-546-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTT",
        "first_name": "GINI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125053538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisa Crespo Pavlatos
• Kelley Dagdick
• Elizabeth Ann Delimat, OTR/L
• Marinela Dilo, DMD
• Rebecca Dressendorfer, M.S. CCC-SLP
• Joy Christina Dziadkowiec, CNA
• Linda Lee Eaton, LMT
• Elite Therapeutics and Healthcare, Inc
• Susana Emerick
• Paul Eubanks, LMT

• Internal Medicine Physician in Round Lake, IL
• Providers in Round Lake, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; 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.