NPIMap

Organization Active NPI

Christina H Dothager MD LLC

Doing business as Serene Women's Wellness

  • Clinic/Center
  • O'Fallon, IL
National Provider Identifier
1740776251
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CHRISTINA H DOTHAGER MD LLC
Doing business as
Serene Women's Wellness
Practice address
787 Sunset Blvd Ste 200
O Fallon, IL 62269-1960
Phone
(618) 726-2229
NPI assigned
Jul 9, 2018
Last updated
Aug 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Authorized official

Name
Rebecca Hathaway
Title
Office Administrator
Phone
(618) 292-4887

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

787 Sunset Blvd Ste 200
O Fallon, IL 62269-1960

Mailing address

787 Sunset Blvd Ste 200
O Fallon, IL 62269-1960
Phone (618) 726-2229

Other practice location 1

Christina H Dothager MD LLC
200 Healthcare Drive, Outpatient Clincis
Greenville, IL 62246
Phone (618) 726-2229

Other identifiers 1

IdentifierTypeStateIssuer
036-125618MedicaidIL

Other names 1

  • Serene Women's Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180828001315 IL Part B Supplier - Clinic/Group Practice 9931458791 Receives reassigned benefits from 6 practitioners
Practice locations: O Fallon, IL

National Provider Directory

National Provider Directory

Locations

787 Sunset Blvd
#200
O Fallon, IL 62269
Phone (618) 624-2400

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1740776251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 SUNSET BLVD STE 200",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691960",
            "telephone_number": "618-726-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 SUNSET BLVD STE 200",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691960",
            "telephone_number": "618-726-2229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Christina H Dothager MD LLC",
            "address_2": "200 Healthcare Drive, Outpatient Clincis",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "IL",
            "postal_code": "62246",
            "country_code": "US",
            "telephone_number": "618-726-2229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHRISTINA H DOTHAGER MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-09",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A",
        "authorized_official_last_name": "HATHAWAY",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "618-292-4887"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-125618",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serene Women's Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Serene Women's Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in O'Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.