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Individual provider Active NPI

Dinora Ingberman, MD

  • Physical Medicine & Rehabilitation Physician
  • Skokie, IL
National Provider Identifier
1609861657
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
036-083386 Issued in IL
Practice address
9669 Kenton Ave
Suite 405
Skokie, IL 60076-1266
Phone
(630) 789-2550
Fax
(847) 675-7595
NPI assigned
Sep 15, 2005
Last updated
Jul 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 036-083386 IL Primary

Addresses

Primary practice location

9669 Kenton Ave
Suite 405
Skokie, IL 60076-1266

Mailing address

9669 N. Kenton St
510
Skokie, IL 60076-1545
Phone (847) 675-1064

Other identifiers 4

IdentifierTypeStateIssuer
260037069OtherILRAIL ROAD MEDICARE
036083386MedicaidIL
01622674OtherILBCBS PROVIDER ID
P00198132OtherILRAIL ROAD MEDICARE

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
I20040714001212 IL Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 7315926342 Reassigns benefits to 1 organization
Practice locations: Gurnee, IL; Lake Forest, IL; Skokie, IL

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Rush Medical College of Rush University, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9669 N Kenton Ave
Skokie, IL 60076-1267
Phone (847) 675-1064

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue387
Removal of skin lesions59
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-083386ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Solutions, LLC CurrentSince Jan 1, 2022 Accepting new patients
Northwestern Lake Forest Hospital Past Accepting new patients
North Shore Psychological Services LTD Past Accepting new patients
Linda F Gruenberg DO SC Past Accepting new patients
Ronald P Pawl MD SC Past Accepting new patients
European Healing Center, Inc Past Accepting new patients

Locations

9669 Kenton Ave
Ste 405
Skokie, IL 60076
Phone (847) 933-0500

9669 Kenton Ave
Ste 510
Skokie, IL 60076
Phone (847) 675-1064

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 6

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1609861657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9669 N. KENTON ST",
            "address_2": "510",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761545",
            "telephone_number": "847-675-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE",
            "address_2": "SUITE 405",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761266",
            "telephone_number": "630-789-2550",
            "fax_number": "847-675-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGBERMAN",
        "first_name": "DINORA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036-083386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "260037069",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036083386",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "01622674",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00198132",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.