Individual provider Active NPI

Thierry J Dubois, M.D.

  • Family Medicine Physician
  • Orland Park, IL
National Provider Identifier
1912932161
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-111877 Issued in IL
Practice address
15300 West Ave
Orland Park, IL 60462-4600
Phone
(708) 460-5550
Fax
(708) 226-2595
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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 036-111877 IL
Family Medicine Physician 207Q00000X 036-111877 IL Primary

Addresses

Primary practice location

15300 West Ave
Orland Park, IL 60462-4600

Mailing address

15300 West Ave Ste 20
Orland Park, IL 60462-4504
Phone (708) 460-0500

Other identifiers 1

IdentifierTypeStateIssuer
36111877MedicaidIL

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
I20041008001353 IL Practitioner - Family PracticePractitioner - Emergency Medicine 7214996719 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

15300 W Ave
Suite 20 LL Building D
Orland Park, IL 60462-4504
Phone (708) 460-5550

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-111877ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Central Dupage Physician Group Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Oct 31, 2017 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Oct 31, 2017 Accepting new patients
Edward Hospital CurrentSince Aug 19, 2017 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Edward Hospital CurrentSince Aug 19, 2017 Accepting new patients
Central Dupage Physician Group CurrentSince Aug 1, 2021 Accepting new patients
Emergency Care Physician Services Emergency Medicine Past Accepting new patients
Unimed, LTD Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

8131 S May St
Chicago, IL 60620
Phone (312) 365-5801

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

7732 Solutions Ctr
Chicago, IL 60677

55 W Cermak Rd
Chicago, IL 60616
Phone (312) 326-4472

2701 W 68th St
Chicago, IL 60629
Phone (773) 471-8000

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

21202 Owens Rd
Ste 101
Mokena, IL 60448
Phone (779) 334-0030

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

15300 West Ave
Orland Park, IL 60462
Phone (708) 226-2440

15300 West Ave
Ste 20
Orland Park, IL 60462
Phone (708) 460-5550

12251 S 80th Ave
Palos Heights, IL 60463
Phone (708) 361-4500

1324 N Sheridan Rd
Waukegan, IL 60085
Phone (847) 360-3000

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Interoperability endpoints

  • Direct secure messaging: tdubois60803@direct.et0946.epichosted.com
  • FHIR API: https://fhirprd.edward.org/fhirprd/api/FHIR/R4/

Organizations & group practices 11

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.

Hospital & facility affiliations 6

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1912932161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15300 WEST AVE STE 20",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624504",
            "telephone_number": "708-460-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 WEST AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624600",
            "telephone_number": "708-460-5550",
            "fax_number": "708-226-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "THIERRY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-111877",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-111877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36111877",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.