Mr Christopher M Dolak, AGNP-C in Springfield, IL

Mr Christopher M Dolak, AGNP-C is a medicare enrolled "Nurse Practitioner - Adult Health" in Springfield, Illinois. His current practice location is 2501 Chatham Rd Ste N, Springfield, Illinois. You can reach out to his office (for appointments etc.) via phone at (815) 781-2608.

Mr Christopher M Dolak is licensed to practice in Illinois (license number 209-031384) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1073323200.

Contact Information

	Mr Christopher M Dolak, AGNP-C
	2501 Chatham Rd Ste N, Springfield, IL 62704-4188
	(815) 781-2608
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Christopher M Dolak
Gender	Male
Speciality	Nurse Practitioner - Adult Health
Location	2501 Chatham Rd Ste N, Springfield, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073323200
Provider Enumeration Date: 01/09/2025
Last Update Date: 01/09/2025

Medicare PECOS Information:

PECOS PAC ID: 5496271553
Enrollment ID: I20250501001075

Medical Identifiers

Medical identifiers for Mr Christopher M Dolak such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073323200	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2200X	Nurse Practitioner - Adult Health	209-031384 (Illinois)	Primary
363LG0600X	Nurse Practitioner - Gerontology	209-031384 (Illinois)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Christopher M Dolak allows following entities to bill medicare on his behalf.

Entity Name	Illinois Wound Care Centers Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1255912341 PECOS PAC ID: 6800280165 Enrollment ID: O20220302001451

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Christopher M Dolak is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Christopher M Dolak, AGNP-C 1721 W Hollow St, Mchenry, IL 60051-7545 Ph: (224) 650-9237	Mr Christopher M Dolak, AGNP-C 2501 Chatham Rd Ste N, Springfield, IL 62704-4188 Ph: (815) 781-2608

Reviews and Comments

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Mr Christopher M Dolak, AGNP-C - Medicare Nurse Practitioner in Springfield, IL