Individual provider Active NPI

Da Young Song, MD

  • Internal Medicine Physician
  • Mokena, IL
National Provider Identifier
1952982183
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.170906 Issued in IL
Practice address
21202 Owens Rd Ste 201
Mokena, IL 60448-2038
Phone
(779) 334-0020
Fax
(779) 334-0021
NPI assigned
Apr 19, 2021
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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 036.170906 IL Primary

Addresses

Primary practice location

21202 Owens Rd Ste 201
Mokena, IL 60448-2038

Mailing address

21202 Owens Rd Ste 201
Mokena, IL 60448-2038
Phone (779) 334-0020

Other practice location 1

12251 S 80th Ave
Palos Heights, IL 60463-1290
Phone (708) 923-4000

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
I20240723001349 IL Practitioner - Internal Medicine 3779985221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

21202 Owens Rd
Suite 201
Mokena, IL 60448-2038
Phone (779) 334-0020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.170906ILMDInternal Medicine Physician

Organizations & group practices 1

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": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1952982183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21202 OWENS RD STE 201",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482038",
            "telephone_number": "779-334-0020",
            "fax_number": "779-334-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21202 OWENS RD STE 201",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482038",
            "telephone_number": "779-334-0020",
            "fax_number": "779-334-0021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12251 S 80th Ave",
            "address_purpose": "LOCATION",
            "city": "Palos Heights",
            "state": "IL",
            "postal_code": "604631290",
            "country_code": "US",
            "telephone_number": "708-923-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "DA YOUNG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.170906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

Verify at the official NPI Registry.