Individual provider Active NPI

David J Knysak, MD

  • Allergy & Immunology Physician
  • Elmhurst, IL
National Provider Identifier
1609876101
Registry record updated Mar 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
036076995 Issued in IL
Practice address
360 W Butterfield Rd Ste 140
Elmhurst, IL 60126-5025
Phone
(630) 574-0460
Fax
(630) 574-0470
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 036076995 IL Primary

Addresses

Primary practice location

360 W Butterfield Rd Ste 140
Elmhurst, IL 60126-5025

Mailing address

360 W Butterfield Rd Ste 140
Elmhurst, IL 60126-5025
Phone (630) 574-0460

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
I20100618000826 IL Practitioner - Allergy/Immunology 8628072246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Northwestern University Feinberg Medical School, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Brook Allergists SCGroup PAC ID 7911901525, 3 clinicians

Practice addresses (Care Compare)

360 W Butterfield Rd
Suite 140
Elmhurst, IL 60126-5025
Phone (630) 574-0460

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Brook Allergists SC Allergy & Immunology CurrentSince Jul 1, 1992 Accepting new patients

Locations

6800 Main St
Ste 110
Downers Grove, IL 60516
Phone (630) 789-0575

360 W Butterfield Rd
Ste 140
Elmhurst, IL 60126
Phone (630) 574-0460

1220 Hobson Rd
Ste 114
Naperville, IL 60540
Phone (630) 574-0460

120 Oakbrook Ctr
Ste 424
Oak Brook, IL 60523
Phone (630) 574-0460

24600 W 127th St
Bldg B
Plainfield, IL 60585
Phone (815) 267-8825

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1609876101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W BUTTERFIELD RD STE 140",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265025",
            "telephone_number": "630-574-0460",
            "fax_number": "630-574-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W BUTTERFIELD RD STE 140",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265025",
            "telephone_number": "630-574-0460",
            "fax_number": "630-574-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNYSAK",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "036076995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.