Individual provider Active NPI

Mark Timothy Monahan, M.D.

  • Emergency Medicine Physician
  • Dixon, IL
National Provider Identifier
1518998327
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036107925 Issued in IL
Practice address
403 E 1St St
Dixon, IL 61021-3116
Phone
(815) 288-5531
Fax
(815) 285-5558
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01057437A IN
Emergency Medicine Physician 207P00000X 036107925 IL Primary

Addresses

Primary practice location

403 E 1St St
Dixon, IL 61021-3116

Mailing address

403 E 1St St
Dixon, IL 61021-3116
Phone (815) 288-5531

Other practice location 1

615 N Michigan St
South Bend, IN 46601-1033
Phone (574) 647-7459

Other identifiers 4

IdentifierTypeStateIssuer
4782693MedicaidMI
036109925OtherILPHYSICIAN LICENSE
200432460MedicaidIN
000000282214OtherINANTHEM PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110128000107 IN Practitioner - Emergency Medicine 7113106790 Reassigns benefits to 3 organizations
I20160920001816 IL Practitioner - Emergency Medicine 7113106790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Chicago, Pritzker School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians
South Bend Emergency Physicians IncGroup PAC ID 0941282354, 51 clinicians

Practice addresses (Care Compare)

403 E 1St St
Dixon, IL 61021-3116
Phone (815) 288-5531

615 N Michigan St
South Bend, IN 46601-1033
Phone (574) 647-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Woodlawn Hospital CurrentSince Jun 20, 2017 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
North Indiana Emergency Physicians, LLP Emergency Medicine CurrentSince Sep 1, 2017 Accepting new patients
Woodlawn Hospital Current Accepting new patients
Woodlawn Hospital Emergency Medicine CurrentSince Jun 20, 2017 Accepting new patients
South Bend Emergency Physicians, Inc Emergency Medicine CurrentSince Jan 1, 2019 Accepting new patients
Osf Multi-Specialty Group CurrentSince Apr 18, 2025 Accepting new patients
Katherine Shaw Bethea Hospital CurrentSince Apr 22, 2019 Accepting new patients

Locations

403 E 1st St
Dixon, IL 61021
Phone (815) 285-5629

695 N Kellogg St
Galesburg, IL 61401
Phone (309) 343-8131

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1020 High Rd
Bremen, IN 46506
Phone (574) 309-9967

3220 Beacon Pkwy
Granger, IN 46530
Phone (574) 647-8788

1501 Hartford St
Lafayette, IN 47904
Phone (765) 423-6011

1007 Lincolnway
Laporte, IN 46350
Phone (219) 325-5474

3630 Willowcreek Rd
Portage, IN 46368
Phone (219) 364-3000

1400 E 9th St
Rochester, IN 46975
Phone (574) 223-2020

615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

Organizations & group practices 8

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 5

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1518998327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213116",
            "telephone_number": "815-288-5531",
            "fax_number": "815-285-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213116",
            "telephone_number": "815-288-5531",
            "fax_number": "815-285-5558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 N Michigan St",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011033",
            "country_code": "US",
            "telephone_number": "574-647-7459",
            "fax_number": "574-284-3342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONAHAN",
        "first_name": "MARK",
        "middle_name": "TIMOTHY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01057437A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036107925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4782693",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "036109925",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200432460",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000282214",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

Verify at the official NPI Registry.