Individual provider Active NPI

Dinah Kate Hamilton Thibeault, M.D.

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1780116590
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036.152927 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone
(773) 702-6602
NPI assigned
Mar 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 287837 MA
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 036.152927 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637-1443

Mailing address

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (773) 702-6602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MA2 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
I20200701001028 IL Practitioner - Pediatric Medicine 7416370986 Reassigns benefits to 2 organizations
I20210921003246 MA Practitioner - Pediatric Medicine 7416370986 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.152927ILMDPediatrics Physician
287837MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center Single Specialty CurrentSince Oct 10, 2023 Accepting new patients
The University of Chicago Medical Center CurrentSince Oct 10, 2023 Accepting new patients
University of Chicago Single Specialty CurrentSince Oct 10, 2023 Accepting new patients
Pratt Pediatric Associates Inc Single Specialty CurrentSince Aug 5, 2021 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

6501 S Promontory Dr
Chicago, IL 60649
Phone (773) 256-5724

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

800 Washington St
#1013
Boston, MA 02111
Phone (617) 636-0491

800 Washington St
#7071
Boston, MA 02111

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

Interoperability endpoints

  • Direct secure messaging: dinah.thibeault.1@11074.direct.athenahealth.com
  • Direct secure messaging: dhamiltonthibeault277189@uchospital.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1780116590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-702-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-702-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBEAULT",
        "first_name": "DINAH KATE",
        "middle_name": "HAMILTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "287837",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.152927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.