Individual provider Active NPI

Brian Patrick Dumais, M.D.

  • Pediatrics Physician
  • Orland Park, IL
National Provider Identifier
1376695577
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Practice address
15030 S Ravinia Ave
Suite 38
Orland Park, IL 60462-3256
Phone
(708) 364-1600
Fax
(708) 364-1695
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X IL Primary

Addresses

Primary practice location

15030 S Ravinia Ave
Suite 38
Orland Park, IL 60462-3256

Mailing address

15030 S Ravinia Ave
Suite 38
Orland Park, IL 60462-3256
Phone (708) 364-1600

Other identifiers 2

IdentifierTypeStateIssuer
0001635627OtherILBLUE CROSS BLUE SHIELD
20694OtherILADVOCATE HELATH PARTNERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036111602ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1376695577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15030 S RAVINIA AVE",
            "address_2": "SUITE 38",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623256",
            "telephone_number": "708-364-1600",
            "fax_number": "708-364-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15030 S RAVINIA AVE",
            "address_2": "SUITE 38",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623256",
            "telephone_number": "708-364-1600",
            "fax_number": "708-364-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMAIS",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001635627",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVOCATE HELATH PARTNERS",
            "identifier": "20694",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.