Elton Wade Dixon, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

36099059 Issued in IL

Practice address

535 S Washington St
Ste 22
Naperville, IL 60540-6795

Phone

(630) 810-0451

Fax

(877) 446-3870

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Suburban Pain Care Surgical Facility LLC

  • Specialist
  • Tinley Park, IL
  • NPI 1912157108
  NPD (past) Authorized official
• Suburban Surgical Facility

  • Ambulatory Surgical Clinic/Center
  • Tinley Park, IL
  • NPI 1720165723
  NPD (past) Authorized official
• Joliet Pain Care Center

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Joliet, IL
  • NPI 1043322001
  NPD (past)
• Pain Care America

  • Physical Medicine & Rehabilitation Physician
  • Darien, IL
  • NPI 1912019977
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1881703387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 S WASHINGTON ST",
            "address_2": "STE 22",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406795",
            "telephone_number": "630-810-0451",
            "fax_number": "877-446-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S WASHINGTON ST",
            "address_2": "STE 22",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406795",
            "telephone_number": "630-810-0451",
            "fax_number": "877-446-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "ELTON",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "36099059",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "010576564",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Satish Divekar
• Diverse Legacy Incorporated
• Jamey Divietro, M.A., L.C.P.C.
• Divine Covenant Staffing Services LLC
• Rajeev S Dixit, MD
• Mark Richard Dixon, PH.D. BCBA-D
• DK Chiropractic Wellness Center LLC
• DLD Clinical Associates, LLC
• Caroline Dluski Guerra, DNP
• DMG Pain Management Surgery Center, LLC

• Physical Medicine & Rehabilitation Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.