Individual provider Active NPI

Josephine Y. Dinkha, M. D.

  • Family Medicine Physician
  • Oak Lawn, IL
National Provider Identifier
1518151679
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036117453 Issued in IL
Practice address
4861 W 95TH St
Southwest Management Systems Inc.
Oak Lawn, IL 60453
Phone
(708) 425-9096
Fax
(708) 499-0993
NPI assigned
Aug 31, 2007
Last updated
Feb 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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 036117453 IL Primary

Addresses

Primary practice location

4861 W 95TH St
Southwest Management Systems Inc.
Oak Lawn, IL 60453

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-1322
Phone (630) 469-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdinkha188753@direct.edward.org

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
I20081009000284 IL Practitioner - Family Practice 2062580640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of LakeGroup PAC ID 7214838861, 42 clinicians

Practice addresses (Care Compare)

1911 27TH St
Zion, IL 60099-2542
Phone (847) 377-8800

2400 Belvidere Rd
Waukegan, IL 60085-6165
Phone (847) 377-8800

2410 Belvidere Rd
Waukegan, IL 60085-6165
Phone (847) 377-8686

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036117453ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lake CurrentSince Feb 16, 2012 Accepting new patients
County of Lake CurrentSince Feb 16, 2012 Accepting new patients
County of Lake Past Accepting new patients

Locations

2400 Belvidere Rd
Waukegan, IL 60085
Phone (847) 377-8400

3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296

Interoperability endpoints

  • Direct secure messaging: josephine.dinkha.p1@direct.lakecountyil.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1518151679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606741322",
            "telephone_number": "630-469-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4861 W 95TH ST",
            "address_2": "SOUTHWEST MANAGEMENT SYSTEMS INC.",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60453",
            "telephone_number": "708-425-9096",
            "fax_number": "708-499-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINKHA",
        "first_name": "JOSEPHINE",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036117453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdinkha188753@direct.edward.org",
            "affiliation": "N",
            "address_1": "4861 W 95th St",
            "address_2": "Southwest Management Systems Inc.",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.