Individual provider Active NPI

Holly S Carobene, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Crystal Lake, IL
National Provider Identifier
1326140633
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
036074517 Issued in IL
Practice address
360 Station Dr Ste 100
Crystal Lake, IL 60014
Phone
(815) 477-0174
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036074517 IL
Interventional Pain Medicine Physician 208VP0014X 036074517 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X 036074517 IL Primary

Addresses

Primary practice location

360 Station Dr Ste 100
Crystal Lake, IL 60014

Mailing address

360 Station Dr Ste 300
Crystal Lake, IL 60014-8003
Phone (815) 338-6600

Other practice location 1

71 W 156th St
Suite 205
Harvey, IL 60426-4260
Phone (708) 596-3344

Other practice location 2

360 Station Dr Ste 100
Crystal Lake, IL 60014
Phone (815) 477-0174

Other identifiers 1

IdentifierTypeStateIssuer
036074517OtherILSTATE LICENSE

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
I20040928000694 IL Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 2062405061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Anesthesiology
Education
Northwestern University Feinberg Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

360 Station Dr
Suite 300
Crystal Lake, IL 60014-8003
Phone (815) 344-3900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036074517ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince May 1, 2019 Accepting new patients
Central Dupage Physician Group CurrentSince May 1, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 4, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 4, 2024 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

360 Station Dr
Ste 100
Crystal Lake, IL 60014
Phone (815) 334-5566

360 Station Dr
Ste 300
Crystal Lake, IL 60014
Phone (815) 455-1800

77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407

11650 S State Route 47
Huntley, IL 60142
Phone (847) 802-7300

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1326140633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 STATION DR STE 300",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600148003",
            "telephone_number": "815-338-6600",
            "fax_number": "815-356-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 STATION DR STE 100",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "815-477-0174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 W 156th St",
            "address_2": "SUITE 205",
            "address_purpose": "LOCATION",
            "city": "Harvey",
            "state": "IL",
            "postal_code": "604264260",
            "country_code": "US",
            "telephone_number": "708-596-3344",
            "fax_number": "708-596-3432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Station Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "60014",
            "country_code": "US",
            "telephone_number": "815-477-0174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAROBENE",
        "first_name": "HOLLY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036074517",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036074517",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036074517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036074517",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.