Individual provider Active NPI

Jay M Dutton, M.D.

  • Otolaryngology Physician
  • Downers Grove, IL
National Provider Identifier
1700886116
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036100227 Issued in IL
Practice address
3800 Highland Ave Ste 105
Downers Grove, IL 60515-1558
Phone
(630) 701-3840
Fax
(630) 574-8225
NPI assigned
Jul 28, 2005
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 036100227 IL Primary

Addresses

Primary practice location

3800 Highland Ave Ste 105
Downers Grove, IL 60515-1558

Mailing address

3800 Highland Ave Ste 105
Downers Grove, IL 60515-1558
Phone (630) 701-3840

Other identifiers 1

IdentifierTypeStateIssuer
036100227MedicaidIL

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
I20051021000265 IL Practitioner - Otolaryngology 7012933773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Iowa, RJ & L Carver College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Head and Neck Associates SCGroup PAC ID 6103842950, 6 clinicians

Practice addresses (Care Compare)

3800 Highland Ave
Suite 105
Downers Grove, IL 60515-1558
Phone (630) 701-3840

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Head and Neck Associates, SC Otolaryngology CurrentSince Jul 1, 1999 Accepting new patients
William Panje MD SC Past Accepting new patients

Locations

1725 W Harrison St
Ste 340
Chicago, IL 60612
Phone (312) 563-9805

3000 N Halsted St
Ste 721
Chicago, IL 60657
Phone (312) 664-6715

3800 Highland Ave
Ste 105
Downers Grove, IL 60515
Phone (630) 574-8222

120 Oakbrook Ctr
Ste 508
Oak Brook, IL 60523
Phone (630) 574-8222

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 5

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1700886116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 HIGHLAND AVE STE 105",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151558",
            "telephone_number": "630-701-3840",
            "fax_number": "630-574-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 HIGHLAND AVE STE 105",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151558",
            "telephone_number": "630-701-3840",
            "fax_number": "630-574-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTON",
        "first_name": "JAY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036100227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100227",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.