Patricia Lynn Kessler Bookhout, DMD
Individual provider Active NPI General Practice Dentistry · Olney, IL
NPI 1336211523 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1336211523
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Practice address
- 1104 North East
Olney, IL 62450 - Phone
- (618) 392-2811
- Fax
- (618) 395-1638
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Owned or controlled facilities with NPI records 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Carle Richland Memorial Hospital |
Hospital | Corporate Director | Oct 1, 2019 |
| Carle Richland Memorial Hospital |
Hospital | Corporate Director | Oct 1, 2019 |
| Carle RMH West Salem Rural Health Clinic |
Rural health clinic | Corporate Director | Oct 1, 2019 |
| Carle RMH Primary Care |
Rural health clinic | Corporate Director | Oct 1, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150615001748 | IL | Order and Referring Only - Oral Surgery |
3971814195 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019023589 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richland Memorial Hospital, Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Yes | |
| Dentist | 122300000X | IL |
Addresses
Primary practice location
1104 North East
Olney, IL 62450
Mailing address
1104 North East
Olney, IL 62450
Phone (618) 392-2811
Other providers in Olney, IL
- David Judy
- Kristen Jurgilanis
- Ashley R Keepes
- Ember Keller
- Hollie A Kelly
- Michelle Kidwell
- Cynthia Louise Kieffer
- Julie Kimbrell
- April Kirkpatrick
- Jeffrey Alan Kocher
All providers in Olney, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.