Individual provider Active NPI

Zachary J Fulton, M.D.

  • Family Medicine Physician
  • Dixon, IL
National Provider Identifier
1982676656
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036111932 Issued in IL
Practice address
403 E 1St St
Dixon, IL 61021-3116
Phone
(815) 285-5629
Fax
(815) 285-5634
NPI assigned
Feb 6, 2006
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036111932 IL Primary
Hospitalist Physician 208M00000X 036111932 IL

Addresses

Primary practice location

403 E 1St St
Dixon, IL 61021-3116

Mailing address

403 E 1St St
Dixon, IL 61021-3116
Phone (815) 285-5629

Other practice location 1

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

Other practice location 2

1405 E 12th St Ste 200
Mendota, IL 61342-9011
Phone (815) 539-1710

Other identifiers 1

IdentifierTypeStateIssuer
036111932MedicaidIL

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
I20050125000991 IL Practitioner - Family Practice 2961452131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeport Memorial HospitalGroup PAC ID 8426958232, 168 clinicians

Practice addresses (Care Compare)

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.08 of 100Reported as group
Quality
86.25
Improvement activities
40
Cost
77.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036111932ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Freeport Memorial Hospital CurrentSince Oct 4, 2021 Accepting new patients
KSB Medical Group, Inc. Family Medicine Past Accepting new patients

Locations

1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105

3001 Highland View Dr
Freeport, IL 61032
Phone (815) 235-3165

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1982676656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213116",
            "telephone_number": "815-285-5629",
            "fax_number": "815-285-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213116",
            "telephone_number": "815-285-5629",
            "fax_number": "815-285-5634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1045 W Stephenson St",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "IL",
            "postal_code": "610324864",
            "country_code": "US",
            "telephone_number": "815-599-6000",
            "fax_number": "815-599-7974",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1405 E 12th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mendota",
            "state": "IL",
            "postal_code": "613429011",
            "country_code": "US",
            "telephone_number": "815-539-1710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULTON",
        "first_name": "ZACHARY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036111932",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036111932",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111932",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

Verify at the official NPI Registry.