Dean Spiros Economos, M.D.
Individual provider Active NPI Family Medicine Physician · Ingleside, IL
NPI 1720169758 · NPPES record last updated Feb 16, 2010
Key facts
- NPI
- 1720169758
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036099612 (IL)
- Practice address
- 727 Grand Ave
Ingleside, IL 60041-9748 - Phone
- (847) 973-9640
- Fax
- (847) 973-9639
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
727 W Grand Ave
Ingleside, IL 60041-9748
Phone (847) 973-9640
Hospital & facility affiliations
- Northwestern Medicine Central Dupage Hospital
- Northwestern Medicine McHenry
- Northwestern Lake Forest Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080602000431 | IL | Practitioner - Family Practice | 7214007335 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036099612 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dean S. Economos, MD, SC | Family Medicine | Current |
Accepting new patients |
| Global Care S.C. | Past |
Accepting new patients |
Locations
214 Washington St
Ingleside, IL 60041
Phone (815) 477-8900
727 Grand Ave
Ingleside, IL 60041
Phone (815) 477-8900
Interoperability endpoints
- deaneconomos@economosmdsc.direct.emds.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036099612 | IL | Yes |
Addresses
Primary practice location
727 Grand Ave
Ingleside, IL 60041-9748
Mailing address
727 Grand Ave
Ingleside, IL 60041-9748
Phone (847) 973-9640
Other providers in Ingleside, IL
- Ethan Dennis Dahl
- William C Dam
- Dean S. Economos, MD, SC
- Domenico PLLC
- Jane Brigette Dorado
- Donna Marie Economos
- Fox Lake Fire Protection District
- Fox Lake Fire Protection District
- Fox Lake Foot Care LTD
- Gavin School District 37
All providers in Ingleside, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.