Roman J Dykun, MD
Individual provider Active NPI Otolaryngology Physician · Woodstock, IL
NPI 1982701587 · NPPES record last updated May 9, 2012
Key facts
- NPI
- 1982701587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- License
- 036063771 (IL)
- Practice address
- 2441 Lake Shore Drive
Woodstock, IL 60098 - Phone
- (815) 338-4600
- Fax
- (815) 338-4611
- NPI assigned
- Sep 19, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Otolaryngology
- Education
- Other, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Roman J. Dykun, MD
Practice addresses (Care Compare)
2441 Lake Shore Dr
Woodstock, IL 60098-6911
Phone (815) 338-4600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050804000220 | IL | Practitioner - Otolaryngology | 1456391085 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036063771 | IL | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roman J. Dykun, MD | Otolaryngology | Current |
Accepting new patients |
| Affiliated Ear, Nose and Throat Physicians | Otolaryngology | Past | Accepting new patients |
Locations
27790 W Highway 22
Ste 11
Barrington, IL 60010
Phone (224) 238-3211
11650 S State Route 47
Huntley, IL 60142
Phone (847) 802-7300
214 Washington St
Ingleside, IL 60041
Phone (815) 477-8900
4309 W Medical Center Dr
Ste B100
McHenry, IL 60050
Phone (815) 363-0400
2441 Lake Shore Dr
Woodstock, IL 60098
Phone (815) 338-4600
1065 Lake Ave
Woodstock, IL 60098
Phone (815) 338-4600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 036063771 | IL | Yes |
Addresses
Primary practice location
2441 Lake Shore Drive
Woodstock, IL 60098
Mailing address
2441 Lake Shore Drive
Woodstock, IL 60098
Phone (815) 338-4600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036063771 | Medicaid | IL |
Other providers in Woodstock, IL
- Janyce B Dorr
- Dr Tanveer Ahmad PC
- Christy Marie Drach
- John Druszczak
- Jane Lois Dwyer
- Lauren Easton
- Shelbi Lynn Edens
- Letitia Susan Edgell
- Edna Compassion Home Care LLC
- Rasheeda Eiland
All providers in Woodstock, IL · Otolaryngology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.