Individual provider Active NPI

Jeffrey S Dungan, M.D.

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1790795979
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036.116260 Issued in IL
Practice address
675 N St Clair Street
Galter Suite 14-200
Chicago, IL 60611-5966
Phone
(312) 472-4151
Fax
(312) 472-4564
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X K5911 TX
Obstetrics & Gynecology Physician 207V00000X K5911 TX
Obstetrics & Gynecology Physician 207V00000X 036.116260 IL Primary
Clinical Genetics (M.D.) Physician 207SG0201X 036.116260 IL

Addresses

Primary practice location

675 N St Clair Street
Galter Suite 14-200
Chicago, IL 60611-5966

Mailing address

250 E Superior Street
Suite 05-2174
Chicago, IL 60611-2914
Phone (312) 472-4683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.116260ILMDObstetrics & Gynecology Physician
K5911TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine Past Accepting new patients
Baylor College of Medicine Past Accepting new patients
Baylor College of Medicine Obstetrics & Gynecology Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1790795979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E SUPERIOR STREET",
            "address_2": "SUITE 05-2174",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112914",
            "telephone_number": "312-472-4683",
            "fax_number": "312-472-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N ST CLAIR STREET",
            "address_2": "GALTER SUITE 14-200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115966",
            "telephone_number": "312-472-4151",
            "fax_number": "312-472-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNGAN",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "TX",
            "license": "K5911",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "K5911",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036.116260",
            "primary": true
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "IL",
            "license": "036.116260",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.