Active NPI
W. Paul Dmowski, M.D., PH.D.
- Specialist
- Oak Brook, IL
National Provider Identifier
1487657318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 2425 W 22ND St
Ste 102
Oak Brook, IL 60523-4643 - Phone
- (630) 954-0054
- Fax
- (630) 954-0064
- NPI assigned
- May 24, 2005
- Last updated
- Jan 23, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | IL | Primary |
Addresses
Primary practice location
2425 W 22ND St
Ste 102
Oak Brook, IL 60523-4643
Mailing address
2425 W 22ND St
Ste 102
Oak Brook, IL 60523-4643
Phone (630) 954-0054
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022-15570 | Other | IL | BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 21, 2019 through Jan 21, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036043641 | IL | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W.P. Dmowski, M.D.. PH.D. & Associates S.C. | Specialist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Medical Laboratory
- Oak Brook, IL
- NPI 1376727255
-
- Specialist
- Oak Brook, IL
- NPI 1881716066
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201046400000",
"number": "1487657318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 W 22ND ST",
"address_2": "STE 102",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605234643",
"telephone_number": "630-954-0054",
"fax_number": "630-954-0064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 W 22ND ST",
"address_2": "STE 102",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605234643",
"telephone_number": "630-954-0054",
"fax_number": "630-954-0064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DMOWSKI",
"first_name": "W. PAUL",
"credential": "M.D., PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2008-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "022-15570",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oak Brook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.