NPIMap

Individual provider Active NPI

Dale L. Coy, M.D.

  • Gastroenterology Physician
  • Lake Barrington, IL
National Provider Identifier
1770578858
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036-076418 Issued in IL
Practice address
22285 Pepper Rd.
#311
Lake Barrington, IL 60010
Phone
(847) 382-4410
Fax
(847) 382-4451
NPI assigned
Sep 15, 2005
Last updated
Sep 7, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036-076418 IL Primary

Addresses

Primary practice location

22285 Pepper Rd.
#311
Lake Barrington, IL 60010

Mailing address

22285 Pepper Rd.
#311
Lake Barrington, IL 60010
Phone (847) 382-4410

Other identifiers 1

IdentifierTypeStateIssuer
036-076418OtherILPHYSICIAN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110114000443 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 7618166117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Ohio State University College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gi Partners of Illinois PLLCGroup PAC ID 2567758295, 38 clinicians

Practice addresses (Care Compare)

1880 W Winchester Rd
Suite 201
Libertyville, IL 60048-5336
Phone (630) 952-1400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy206
Upper gastrointestinal (GI) endoscopy for acid reflux156

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-076418ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gi Partners of Illinois, PLLC Gastroenterology CurrentSince Jan 1, 2017 Accepting new patients
Pepper Road Endoscopy Center LLC PastSince Jul 16, 2024 Accepting new patients

Locations

350 E Congress Pkwy
Ste D
Crystal Lake, IL 60014
Phone (847) 639-2999

22285 N Pepper Rd
Ste 311
Lake Barrington, IL 60010
Phone (847) 382-4410

22285 N Pepper Rd
Ste 312
Lake Barrington, IL 60010
Phone 84738206793336

1880 W Winchester Rd
Ste 201
Libertyville, IL 60048
Phone (847) 247-0187

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

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 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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1770578858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22285 PEPPER RD.",
            "address_2": "#311",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "60010",
            "telephone_number": "847-382-4410",
            "fax_number": "847-382-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22285 PEPPER RD.",
            "address_2": "#311",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "60010",
            "telephone_number": "847-382-4410",
            "fax_number": "847-382-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COY",
        "first_name": "DALE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036-076418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "036-076418",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Barrington, IL

Sources for this page

Verify at the official NPI Registry.