NPIMap

Individual provider Active NPI

Michael Dougherty, MD

  • Otolaryngology Physician
  • Park Ridge, IL
National Provider Identifier
1437786407
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036.175584 Issued in IL
Practice address
2604 Dempster St Ste 501
Park Ridge, IL 60068-8429
Phone
(847) 674-5585
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology Physician 207Y00000X 036.175584 IL Primary

Addresses

Primary practice location

2604 Dempster St Ste 501
Park Ridge, IL 60068-8429

Mailing address

2604 Dempster St Ste 501
Park Ridge, IL 60068-8429
Phone (847) 674-5585

Other practice location 1

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098
Phone (503) 494-8211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250703000178 IL Practitioner - Otolaryngology 7113340530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Virginia School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Midwest ENT Alliance PLLCGroup PAC ID 5294276259, 97 clinicians

Practice addresses (Care Compare)

2604 Dempster St
Suite 501
Park Ridge, IL 60068-8429
Phone (847) 674-5585

Hospital & facility affiliations

  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.175584ILMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest ENT Alliance PLLC Otolaryngology CurrentSince Jun 24, 2025 Accepting new patients
Bastian Voice Institute, LLC Otolaryngology PastSince Sep 22, 2003 Accepting new patients
Century Ear Nose and Throat - Head and Neck Surgery Associates LTD Otolaryngology PastSince Jul 18, 1995 Accepting new patients

Locations

3010 Highland Pkwy
Ste 550
Downers Grove, IL 60515
Phone (630) 724-1100

16001 108th Ave
Ste A2
Orland Park, IL 60467
Phone (708) 460-0007

2604 Dempster St
Ste 501
Park Ridge, IL 60068
Phone 8476745585111

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1437786407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST STE 501",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688429",
            "telephone_number": "847-674-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST STE 501",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688429",
            "telephone_number": "847-674-5585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393098",
            "country_code": "US",
            "telephone_number": "503-494-8211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036.175584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.