NPIMap

Individual provider Active NPI

Michele A Danaher, MD

  • Family Medicine Physician
  • Mokena, IL
National Provider Identifier
1679561773
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036 102025 Issued in IL
Practice address
11243 Laporte Rd.
Mokena, IL 60448-1100
Phone
(708) 479-4681
NPI assigned
Oct 12, 2005
Last updated
Jan 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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 036 102025 IL Primary

Addresses

Primary practice location

11243 Laporte Rd.
Mokena, IL 60448-1100

Mailing address

1860 Payshere Cir
Chicago, IL 60674-7240
Phone (630) 469-9200

Other identifiers 2

IdentifierTypeStateIssuer
09900479OtherILBCBS
0361020251MedicaidIL

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
I20041202000338 IL Practitioner - Family Practice 2163488040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rush Medical College of Rush University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

1325 N Meacham Rd
Schaumburg, IL 60173-4824
Phone (630) 469-9200

17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone (708) 226-7000

2100 Glenwood Ave
Joliet, IL 60435-5487
Phone (815) 725-2121

30 Stratford Dr
Bloomingdale, IL 60108-2201
Phone (630) 893-2210

40 S Clay St
Hinsdale, IL 60521-3257

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone (630) 469-9200

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036 102025ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Mar 13, 2017 Accepting new patients
Dupage Medical Group LTD CurrentSince Mar 13, 2017 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

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

330 Madison St
Ste 103
Joliet, IL 60435
Phone (815) 741-2900

11243 W La Porte Rd
Mokena, IL 60448
Phone (708) 479-4681

19401 Wolf Rd
Mokena, IL 60448
Phone (708) 995-1917

Interoperability endpoints

  • Direct secure messaging: mdanaher132671@dulyhealthandcare.direct-ci.com
  • Direct secure messaging: micheledanaher@dmd.allscriptsdirect.net

Organizations & group practices 2

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 10

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1679561773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606747240",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11243 LAPORTE RD.",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604481100",
            "telephone_number": "708-479-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANAHER",
        "first_name": "MICHELE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036 102025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09900479",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361020251",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

Verify at the official NPI Registry.