Individual provider Active NPI

David Eugene Krause, M.D.

  • Otolaryngology Physician
  • Bourbonnais, IL
National Provider Identifier
1760591879
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036061543 Issued in IL
Practice address
475 Brown Blvd Ste 106
Bourbonnais, IL 60914-2325
Phone
(815) 933-8020
Fax
(815) 933-8068
NPI assigned
Aug 30, 2006
Last updated
Oct 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 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 036061543 IL Primary

Addresses

Primary practice location

475 Brown Blvd Ste 106
Bourbonnais, IL 60914-2325

Mailing address

475 Brown Blvd Ste 106
Bourbonnais, IL 60914-2325
Phone (815) 933-8020

Other identifiers 1

IdentifierTypeStateIssuer
036061543MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040224000929 IL Practitioner - Otolaryngology 8123914421 Reassigns benefits to 1 organization
I20250320002589 WA Practitioner - Otolaryngology 8123914421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

475 Brown Blvd
Suite 106
Bourbonnais, IL 60914-2325

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036061543ILMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Feb 10, 2025 Accepting new patients
Multicare Health System CurrentSince Feb 10, 2025 Accepting new patients
Multicare Health System Current Accepting new patients
David E Krause MD LTD Otolaryngology CurrentSince Jun 14, 2010 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

461 Brown Blvd
Ste A
Bourbonnais, IL 60914
Phone (815) 932-7242

475 Brown Blvd
Ste 106
Bourbonnais, IL 60914
Phone (815) 937-8786

375 N Wall St
Ste P620
Kankakee, IL 60901
Phone (815) 928-5098

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1760591879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 BROWN BLVD STE 106",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142325",
            "telephone_number": "815-933-8020",
            "fax_number": "815-933-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BROWN BLVD STE 106",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142325",
            "telephone_number": "815-933-8020",
            "fax_number": "815-933-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSE",
        "first_name": "DAVID",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036061543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061543",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

Verify at the official NPI Registry.