Individual provider Active NPI

Philip Dean Kooiker, MD

  • Otolaryngology Physician
  • Orland Park, IL
National Provider Identifier
1770552192
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036085389 Issued in IL
Practice address
16001 108TH Ave
Orland Park, IL 60467-8788
Phone
(708) 460-0007
Fax
(708) 460-0005
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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 036085389 IL Primary

Addresses

Primary practice location

16001 108TH Ave
Orland Park, IL 60467-8788

Mailing address

16001 108TH Ave
Orland Park, IL 60467-8788
Phone (708) 460-0007

Other identifiers 1

IdentifierTypeStateIssuer
036085389MedicaidIL

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
I20100604001111 IL Practitioner - Otolaryngology 9537157516 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Iowa, RJ & L Carver College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest ENT Alliance PLLCGroup PAC ID 5294276259, 97 clinicians

Practice addresses (Care Compare)

15884 W 127TH St
Suite H
Lemont, IL 60439-7425
Phone (708) 460-0007

Hospital & facility affiliations

  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213
  • Riverside Medical Center Hospital, Kankakee, IL, CCN 140186

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest ENT Alliance PLLC Otolaryngology CurrentSince Nov 1, 2024 Accepting new patients
Century Ear Nose and Throat - Head and Neck Surgery Associates LTD Otolaryngology CurrentSince Jul 18, 1995 Accepting new patients
Bastian Voice Institute, LLC Otolaryngology PastSince Sep 22, 2003 Accepting new patients

Locations

3010 Highland Pkwy
Ste 550
Downers Grove, IL 60515
Phone (630) 724-1100

15884 W 127th St
Ste H
Lemont, IL 60439
Phone (630) 754-8710

15884 W 127th St
Lemont, IL 60439
Phone (708) 460-0007

1900 Silver Cross Blvd
New Lenox, IL 60451
Phone (815) 300-7106

4700 W 95th St
Ste 104
Oak Lawn, IL 60453
Phone (708) 460-0007

16001 108th Ave
Orland Park, IL 60467
Phone (708) 460-0007

16001 108th Ave
Ste A2
Orland Park, IL 60467
Phone (708) 460-0007

10660 W 143rd St
Orland Park, IL 60462
Phone (219) 838-0066

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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 7

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1770552192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16001 108TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678788",
            "telephone_number": "708-460-0007",
            "fax_number": "708-460-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 108TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678788",
            "telephone_number": "708-460-0007",
            "fax_number": "708-460-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOIKER",
        "first_name": "PHILIP",
        "middle_name": "DEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036085389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085389",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.