Individual provider Active NPI

Daniel Lowder, PA-C, ATC

  • Physician Assistant
  • Oak Park, IL
National Provider Identifier
1992102834
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
385.007044 Issued in IL
Practice address
1101 Lake St
Oak Park, IL 60301-1085
Phone
(708) 232-3227
NPI assigned
Nov 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096.003835 IL
Physician Assistant 363A00000X 385.007044 IL Primary

Addresses

Primary practice location

1101 Lake St
Oak Park, IL 60301-1085

Mailing address

1101 Lake St
Oak Park, IL 60301-1085
Phone (708) 232-3227

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240806000727 IL Practitioner - Physician Assistant 1658818828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMS Clinical Services PLLCGroup PAC ID 7517395064, 30 clinicians

Practice addresses (Care Compare)

1100 Jorie Blvd
Oak Brook, IL 60523-2219
Phone (630) 974-6602

14300 S Ravinia Ave
Suite 100
Orland Park, IL 60462-2578
Phone (630) 974-6602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
096.003835ILMDAthletic Trainer
385.007044ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Relief Mental Health PastSince Dec 6, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1992102834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011085",
            "telephone_number": "708-232-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011085",
            "telephone_number": "708-232-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWDER",
        "first_name": "DANIEL",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-20",
        "last_updated": "2023-01-19",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.003835",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "385.007044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.