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COURTNEY L TELLER PA-C
NPI 1417208505
Physician Assistant in Dixon, IL

Active since September 28, 2012PECOS Enrolled
102 S HENNEPIN AVE, DIXON, IL 61021(815) 285-8523(815) 285-8901 Get Directions Write a Review

NPPES record last updated: August 27, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Courtney L Teller Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COURTNEY L TELLER PA-C (NPI 1417208505) is an individual physician assistant in Dixon, Illinois, licensed in Illinois (085004426) and active in the NPI registry since September 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in Dixon.

NPPES Registry Identity

NPI1417208505
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCOURTNEY L TELLERCredential: PA-C
Location Address102 S HENNEPIN AVEDixon, IL 61021-3013
Mailing Address102 S Hennepin AveDixon, IL 61021-3013 · (815) 285-8523 · Fax (815) 285-8901
Phone(815) 285-8523
Fax(815) 285-8901
Sole ProprietorNo
Enumeration DateSeptember 28, 2012
Last NPPES UpdateAugust 27, 2018
✔ NPI 1417208505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IL · 085004426
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
102 S HENNEPIN AVE, Dixon, IL 61021
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Secondary Practice Location 1

Location 1215 E 1st St Ste 215Dixon, IL 61021-3166 · Phone (815) 285-5420 · Fax (815) 285-5426

Other Identifiers 2

Medicaid329785745001IL
Other381220033IL · Medicare

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Courtney L Teller Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61021 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIRK ANTHONY STEWART MD
Family Medicine
102 S HENNEPIN AVE
DIXON, IL 61021
Lee County (815) 285-8520
JOYCE JOHNSON M.D.
Family Medicine
102 S HENNEPIN AVE
DIXON, IL 61021
Lee County (815) 285-8520
MUHAMMAD AMEEN WASIM M.D.
Family Medicine
102 S HENNEPIN AVE
DIXON, IL 61021
Lee County (815) 285-8908
PRANJAL M AGRAWAL M.D.
Internal Medicine
102 S HENNEPIN AVE
DIXON, IL 61021
Lee County (815) 284-7733
JACLYN PRANITA PARAYAO MD
Family Medicine
102 S HENNEPIN AVE
DIXON, IL 61021
Lee County (815) 285-8520
LISA M DENOBRIGA M.D.
Student in an Organized Health Care Education/Training Program
102 S HENNEPIN AVE
DIXON, IL 61021
Lee County (815) 288-7711
SINNISSIPPI CENTERS, INC.
Clinic/Center (Rehabilitation, Substance Use Disorder)
102 S HENNEPIN AVE
DIXON, IL 61021
Lee County (815) 284-6611
TYLER WALSH M.D.
Family Medicine
102 S HENNEPIN AVE
DIXON, IL 61021
Lee County (815) 285-8520

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Courtney Teller's NPI number?

The NPI number for Courtney Teller is 1417208505. It was assigned to this individual provider in the NPPES registry on September 28, 2012.

Where is Courtney Teller located?

Courtney Teller practices at 102 S Hennepin Ave, Dixon, IL 61021. The listed phone number is (815) 285-8523.

What is Courtney Teller's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Courtney Teller enrolled in Medicare?

Yes. Courtney Teller is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Courtney Teller was last updated on August 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.