Individual provider Active NPI

Roxane Holt, MD

  • Maternal & Fetal Medicine Physician
  • New Lenox, IL
National Provider Identifier
1790988905
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
036.140688 Issued in IL
Practice address
1890 Silver Cross Blvd Ste 310
New Lenox, IL 60451-9623
Phone
(630) 545-3612
Fax
(630) 348-3339
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 036.140688 IL Primary

Addresses

Primary practice location

1890 Silver Cross Blvd Ste 310
New Lenox, IL 60451-9623

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 1

IdentifierTypeStateIssuer
194732704MedicaidTX

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rholt208601@dulyhealthandcare.direct-ci.com
Direct Messaging Address rholt208601@direct.edward.org

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
I20160712002878 IL Practitioner - Obstetrics/Gynecology 5991879470 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.140688ILMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Jul 16, 2023 Accepting new patients
Dupage Medical Group LTD CurrentSince Jul 16, 2023 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

1200 S York St
#1120
Elmhurst, IL 60126

133 E Brush Hill Rd
Ste 400
Elmhurst, IL 60126
Phone (630) 432-6340

155 E Brush Hill Rd
#1
Elmhurst, IL 60126

430 Pennsylvania Ave
Ste 340
Glen Ellyn, IL 60137
Phone (630) 545-3612

1890 Silver Cross Blvd
Ste 310
New Lenox, IL 60451
Phone (630) 545-3612

1890 Silver Cross Blvd
Ste 345
New Lenox, IL 60451
Phone (815) 462-9300

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

Interoperability endpoints

  • Direct secure messaging: rholt123584@uchospital.direct-ci.com
  • Direct secure messaging: roxane.holt@direct.myteamcare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1790988905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 SILVER CROSS BLVD STE 310",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519623",
            "telephone_number": "630-545-3612",
            "fax_number": "630-348-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "ROXANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "IL",
            "license": "036.140688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194732704",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rholt208601@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "430 Pennsylvania Ave Ste 340",
            "city": "Glen Ellyn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601374464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rholt208601@direct.edward.org",
            "affiliation": "N",
            "address_1": "1890 Silver Cross Blvd Ste 310",
            "city": "New Lenox",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604519623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

Verify at the official NPI Registry.