Individual provider Active NPI

Dawn Koterbski, PA-C

  • Physician Assistant
  • Algonquin, IL
National Provider Identifier
1700870094
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-001597 Issued in IL
Practice address
1345 Ryan Pkwy
Algonquin, IL 60102
Phone
(847) 658-9555
Fax
(847) 658-2167
NPI assigned
Sep 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001597 IL
Physician Assistant 363A00000X 085-001597 IL Primary

Addresses

Primary practice location

1345 Ryan Pkwy
Algonquin, IL 60102

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other identifiers 1

IdentifierTypeStateIssuer
204142OtherILMEDICARE NUMBER

Other names 1

  • Mrs. Dawn Jenkins Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dkoterbski205044@direct.myadvocateaurora.org
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040706000183 IL Practitioner - Physician Assistant 1557348067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1345 Ryan Pkwy
Algonquin, IL 60102-4530
Phone (847) 658-9555

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

Hospital & facility affiliations

  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291
  • Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-001597ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jul 15, 2013 Accepting new patients
Advocate Health & Hospitals Corp. CurrentSince Jul 15, 2013 Accepting new patients
American Home Visiting Physicians Past Accepting new patients
Global Care S.C. Past Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients

Locations

1345 Ryan Pkwy
Algonquin, IL 60102
Phone (847) 531-5911

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

29373 Network Pl
Chicago, IL 60673

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1700870094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 RYAN PKWY",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "60102",
            "telephone_number": "847-658-9555",
            "fax_number": "847-658-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTERBSKI",
        "first_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-01",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001597",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "204142",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkoterbski205044@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "1345 Ryan Pkwy",
            "city": "Algonquin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1345 Ryan Pkwy",
            "city": "Algonquin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "JENKINS",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Algonquin, IL

Sources for this page

Verify at the official NPI Registry.