Matthew Destefani, MD
Individual provider Active NPI Emergency Medicine Physician · Hinsdale, IL
NPI 1992187074 · NPPES record last updated Dec 4, 2018
Key facts
- NPI
- 1992187074
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 036.146359 (IL)
- Practice address
- 109 Symonds Dr # 578
Hinsdale, IL 60521 - Phone
- (630) 856-6782
- Fax
- (630) 856-5703
- NPI assigned
- Jun 24, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Loyola University of Chicago, Stritch School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dupage Emergency Physicians LTD
Dupage Emergency Physicians Convenient Care LLC
Practice addresses (Care Compare)
3815 Highland Ave
Downers Grove, IL 60515-1500
Phone (630) 275-5900
6840 Main St
Downers Grove, IL 60516-3425
Phone (630) 275-6840
Hospital & facility affiliations
- Advocate Good Samaritan Hospital
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 |
|---|---|---|---|---|
| I20180809000739 | IL | Practitioner - Emergency Medicine | 0547566713 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.146359 | IL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illinois Emergency Medicine Specialists, LLC | Current |
Accepting new patients | |
| Dupage Emergency Physicians Convenient Care LLC | Emergency Medicine | Current |
Accepting new patients |
Locations
500 Remington Blvd
Bolingbrook, IL 60440
Phone (630) 312-5000
6840 Main St
Downers Grove, IL 60516
Phone (630) 275-6840
15900 W 127th St
Lemont, IL 60439
Phone (630) 243-7100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036.146359 | IL | Yes |
Addresses
Primary practice location
109 Symonds Dr # 578
Hinsdale, IL 60521
Mailing address
109 Symonds Dr # 578
Hinsdale, IL 60521-3763
Phone (630) 856-6782
Other practice location 1
4440 W 95th St
Oak Lawn, IL 60453-2600
Phone (708) 684-5375
Other practice location 2
4440 W 95th St
Oak Lawn, IL 60453-2600
Phone (708) 684-5375
Other providers in Hinsdale, IL
- Dekalb Eye Consultants, LLC
- Angela Dennison
- Dermatology Associates of Hinsdale, S.C.
- Shivam Jayanti Desai
- Design PT & Wellness
- Sandeep Devata
- Diabetes & Endocrinology Group, S.C.
- Marie Ann Dicosola
- Anne Didier
- Julia Digangi
All providers in Hinsdale, IL · Emergency Medicine 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 Dec 4, 2018. 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.