Individual provider Active NPI

Carmen T Fotso-Kouatchou, MD

  • Family Medicine Physician
  • West Dundee, IL
National Provider Identifier
1336122902
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036106098 Issued in IL
Practice address
979 W Main St Ste 201
West Dundee, IL 60118-2095
Phone
(800) 323-1743
Fax
(847) 426-1086
NPI assigned
Nov 28, 2005
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036106098 IL Primary

Addresses

Primary practice location

979 W Main St Ste 201
West Dundee, IL 60118-2095

Mailing address

29373 Network PL
Chicago, IL 60673-1293

Other identifiers 1

IdentifierTypeStateIssuer
036106098MedicaidIL

Other names 1

  • Carmen T Fotso Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cfotsokouatchou205122@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20040318000614 IL Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 5698665024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

13900 Quality Dr
Huntley, IL 60142-8098
Phone (847) 961-7800

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

450 W Hwy 22
Neonatology
Barrington, IL 60010-1919
Phone (847) 381-0123

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Apr 3, 2017 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corp. CurrentSince Apr 3, 2017 Accepting new patients
Bonaventure Medical Foundation, LLC Family Medicine PastSince Apr 1, 2009 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

151 Dundee Ave
Ste C
East Dundee, IL 60118
Phone (847) 426-9396

979 W Main St
Ste 201
West Dundee, IL 60118
Phone (800) 323-1743

Interoperability endpoints

  • Direct secure messaging: cfotsokouatchou205122@direct.myadvocateaurora.org

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1336122902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 W MAIN ST STE 201",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601182095",
            "telephone_number": "800-323-1743",
            "fax_number": "847-426-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOTSO-KOUATCHOU",
        "first_name": "CARMEN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036106098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036106098",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cfotsokouatchou205122@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "979 W Main St Ste 201",
            "city": "West Dundee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601182095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "979 W Main St Ste 201",
            "city": "West Dundee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601182095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARMEN",
            "last_name": "FOTSO",
            "middle_name": "T",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Dundee, IL

Sources for this page

Verify at the official NPI Registry.