Active NPI
Facundo Benito Dovale, MD
- Internal Medicine Physician
- Crest Hill, IL
National Provider Identifier
1689798696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036085934
- 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
- Last updated
- Apr 14, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036085934 | IL | Primary |
Addresses
Primary practice location
20660 Caton Farm Rd
Unit F
Crest Hill, IL 60403-1201
Mailing address
20660 Caton Farm Rd
Unit F
Crest Hill, IL 60403-1201
Phone (815) 714-5430
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036085934 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gibson Community Hospital Association | Past | Accepting new patients | |
| DX Physical Therapy & Rehabilitation, LTD. | Past | Accepting new patients |
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.
-
- Chiropractor
- Norridge, IL
- NPI 1265692487
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
NPI Registry JSON
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": [],
"endpoints": [],
"other_names": []
}Other providers in Crest Hill, IL
Sources for this page
- 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.