Facundo Benito Dovale, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036085934 Issued in IL

Practice address

20660 Caton Farm Rd
Unit F
Crest Hill, IL 60403-1201

Phone

(815) 714-5430

Fax

(815) 714-5369

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• DX Physical Therapy & Rehabilitation, LTD.

  • Chiropractor
  • Norridge, IL
  • NPI 1265692487
  NPD (past)
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1689798696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20660 CATON FARM RD",
            "address_2": "UNIT F",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604031201",
            "telephone_number": "815-714-5430",
            "fax_number": "815-714-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20660 CATON FARM RD",
            "address_2": "UNIT F",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604031201",
            "telephone_number": "815-714-5430",
            "fax_number": "815-714-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVALE",
        "first_name": "FACUNDO",
        "middle_name": "BENITO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036085934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1635426",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085934 2",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1620404",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01633171",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085934 3",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James F Derk, D.P.M.
• Aamirah Jeelani Dhar, M.D.
• Diagnostic Services LLC
• Bryce Donkor
• Dophyson Home Care LLC
• Courtney Ann Doyle, MSW, LSW
• Dr Ahsan and Assoc.
• Dropski Counseling, PC
• Heather Anne Dropski, LCPC
• Edward Health Ventures

• Internal Medicine Physician in Crest Hill, IL
• Providers in Crest Hill, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.