Active NPI
Peter S Dumich, MD
- Otolaryngology Physician
- Champaign, IL
National Provider Identifier
1851811343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 036-068888
- Practice address
- 2609 S Nottingham CT
Champaign, IL 61821-6182 - Phone
- (217) 352-1668
- Fax
- (217) 352-6882
- NPI assigned
- Jun 26, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 036-068888 | IL | Primary |
Addresses
Primary practice location
2609 S Nottingham CT
Champaign, IL 61821-6182
Mailing address
2609 S Nottingham CT
Champaign, IL 61821-7014
Phone (217) 352-1668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-068888 | IL | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498435200000",
"number": "1851811343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2609 S NOTTINGHAM CT",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618217014",
"telephone_number": "217-352-1668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2609 S NOTTINGHAM CT",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618216182",
"telephone_number": "217-352-1668",
"fax_number": "217-352-6882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUMICH",
"first_name": "PETER",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-26",
"last_updated": "2017-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IL",
"license": "036-068888",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.