Individual provider Active NPI

Daniel Butterbach, M.D.

  • Emergency Medicine Physician
  • Pontiac, IL
National Provider Identifier
1861419327
Registry record updated Jan 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-096060 Issued in IL
Practice address
2500 W Reynolds St
Pontiac, IL 61764-9774
Phone
(708) 783-9100
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-096060 IL Primary
Emergency Medicine Physician 207P00000X 01054597A IN

Addresses

Primary practice location

2500 W Reynolds St
Pontiac, IL 61764-9774

Mailing address

75 Remitt Dr
Lockbox 1336
Chicago, IL 60675-0001
Phone (866) 916-5259

Other identifiers 1

IdentifierTypeStateIssuer
036096060MedicaidIL

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
I20080822000525 IL Practitioner - Emergency Medicine 5294800496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

5666 E State St
Rockford, IL 61108-2425
Phone (815) 226-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-096060ILMDEmergency Medicine Physician
01054597AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jan 1, 2012 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jan 1, 2012 Accepting new patients
Central Dupage Emergency Physicians, PC Emergency Medicine PastSince Feb 11, 2024 Accepting new patients
Midwest Emergency Northern Illinois Inc Emergency Medicine Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

600 S Randall Rd
Algonquin, IL 60102
Phone (224) 783-4300

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

1225 W Lake St
Melrose Park, IL 60160
Phone (708) 681-3000

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

Organizations & group practices 5

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 5

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231804800000",
    "number": "1861419327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMITT DR",
            "address_2": "LOCKBOX 1336",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606750001",
            "telephone_number": "866-916-5259",
            "fax_number": "231-922-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W REYNOLDS ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617649774",
            "telephone_number": "708-783-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTERBACH",
        "first_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2009-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-096060",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01054597A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096060",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, IL

Sources for this page

Verify at the official NPI Registry.