1. Home
  2. Directory
  3. Illinois
  4. Evergreen Park
  5. Family Medicine
  6. NPI Profile

ELLEN M HENNECKE DOSC
NPI 1780885657
Family Medicine in Evergreen Park, IL

Active since May 30, 2007
3927 W 95TH ST, EVERGREEN PARK, IL 60805(708) 799-8440 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ellen M Hennecke Dosc NPPES

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

ELLEN M HENNECKE DOSC (NPI 1780885657) is a healthcare organization registered as a family medicine in Evergreen Park, Illinois and active in the NPI registry since May 2007. The organization lists Kim Wylie, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1780885657
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameELLEN M HENNECKE DOSC
Location Address3927 W 95TH STEvergreen Park, IL 60805-1903
Mailing Address18141 Dixie Hwy Ste 107Homewood, IL 60430-2241
Phone(708) 799-8440
Organization SubpartNo
Authorized OfficialKim WylieOffice Manager · (708) 799-8440
Enumeration DateMay 30, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1780885657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3927 W 95TH ST, Evergreen Park, IL 60805
Open in Google Maps ↗

Other Identifiers 1

Other01628066IL · Blue Shield

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

RICHARD E ODONNELL DO SC
Family Medicine
3927 W 95TH ST
EVERGREEN PARK, IL 60805
Cook County (708) 799-8440
ELLEN M HENNECKE DO
Family Medicine
3927 W 95TH ST
EVERGREEN PARK, IL 60805
Cook County (708) 952-4566

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 Ellen M Hennecke Dosc's NPI number?

The NPI number for Ellen M Hennecke Dosc is 1780885657. It was assigned to this organization in the NPPES registry on May 30, 2007.

Where is Ellen M Hennecke Dosc located?

Ellen M Hennecke Dosc is located at 3927 W 95th St, Evergreen Park, IL 60805. The listed phone number is (708) 799-8440.

What is Ellen M Hennecke Dosc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Ellen M Hennecke Dosc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.