Individual provider Active NPI

Richard Krouse, MD

  • Internal Medicine Physician
  • Lisle, IL
National Provider Identifier
1881661759
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036072571 Issued in IL
Practice address
430 Warrenville Rd Ste 210
Lisle, IL 60532
Phone
(630) 873-8875
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036072571 IL Primary

Addresses

Primary practice location

430 Warrenville Rd Ste 210
Lisle, IL 60532

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
036072571MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rkrouse2213@direct.edward.org
Direct Messaging Address rkrouse2213@dulyhealthandcare.direct-ci.com

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
I20040127000238 IL Practitioner - Internal Medicine 8729980966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Creighton University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036072571ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Oct 18, 2000 Accepting new patients
Dupage Medical Group LTD CurrentSince Oct 18, 2000 Accepting new patients

Locations

303 W Lake St
Ste 105
Addison, IL 60101
Phone (708) 628-8889

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

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

430 Warrenville Rd
Lisle, IL 60532
Phone (630) 432-6180

430 Warrenville Rd
Ste 210
Lisle, IL 60532
Phone (630) 432-6180

2340 S Highland Ave
Ste 370
Lombard, IL 60148
Phone (630) 351-0775

Interoperability endpoints

  • Direct secure messaging: rkrouse2213@dulyhealthandcare.direct-ci.com
  • Direct secure messaging: rkrouse2213@direct.edward.org

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1881661759",
    "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": "430 WARRENVILLE RD STE 210",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "60532",
            "telephone_number": "630-873-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROUSE",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036072571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036072571",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkrouse2213@direct.edward.org",
            "affiliation": "N",
            "address_1": "430 Warrenville Rd Ste 210",
            "city": "Lisle",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60532",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkrouse2213@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "430 Warrenville Rd Ste 210",
            "city": "Lisle",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

Verify at the official NPI Registry.