Individual provider Active NPI

Sean Watts, MD

  • Emergency Medicine Physician
  • McHenry, IL
National Provider Identifier
1609370469
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036154939 Issued in IL
Practice address
4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone
(815) 759-3100
Fax
(815) 363-9094
NPI assigned
Mar 19, 2018
Last updated
Sep 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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 125.072234 IL
Emergency Medicine Physician 207P00000X 036154939 IL Primary

Addresses

Primary practice location

4201 W Medical Center Dr
McHenry, IL 60050-8409

Mailing address

4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone (815) 759-3100

Other practice location 1

251 E Huron St
Chicago, IL 60611
Phone (312) 926-2000

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
I20211208000221 IL Practitioner - Emergency Medicine 2961746698 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rush Medical College of Rush University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Emergency Physicians Convenient Care LLCGroup PAC ID 6608840046, 30 clinicians
Dupage Emergency Physicians LTDGroup PAC ID 6507854288, 27 clinicians

Practice addresses (Care Compare)

15900 W 127TH St
Lemont, IL 60439-2910
Phone (630) 243-7100

3815 Highland Ave
Downers Grove, IL 60515-1500
Phone (630) 275-5900

4201 W Medical Ctr Dr
McHenry, IL 60050-8409
Phone (815) 759-4323

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036154939ILMDEmergency Medicine Physician
125.072234ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2022 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Dupage Emergency Physicians Convenient Care LLC Emergency Medicine CurrentSince Mar 1, 2023 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2022 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

211 E Ontario St
Ste 200
Chicago, IL 60611
Phone (312) 694-7000

251 E Huron St
Chicago, IL 60611

6840 Main St
Downers Grove, IL 60516
Phone (630) 275-2600

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

15900 W 127th St
Lemont, IL 60439
Phone (630) 243-7100

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

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

Organizations & group practices 6

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 3

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": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1609370469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409",
            "telephone_number": "815-759-3100",
            "fax_number": "815-363-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409",
            "telephone_number": "815-759-3100",
            "fax_number": "815-363-9094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 E Huron St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "312-926-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTS",
        "first_name": "SEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.072234",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036154939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.