Dr Anton N Dietzen, MD, DC is a medicare enrolled "Physical Medicine & Rehabilitation - Pediatric Rehabilitation Medicine" provider in Chicago, Illinois. His current practice location is
1750 W Harrison St, Chicago, Illinois. You can reach out to his office (for appointments etc.) via phone at
(312) 942-6510.
Dr Anton N Dietzen is licensed to practice in Illinois (license number 036149703) 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 1063659076.
Healthcare Provider's Profile
| Full Name | Dr Anton N Dietzen |
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| Gender | Male |
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| Speciality | Physical Medicine & Rehabilitation - Pediatric Rehabilitation Medicine |
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| Location | 1750 W Harrison St, Chicago, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1063659076
- Provider Enumeration Date: 01/13/2009
- Last Update Date: 09/12/2023
Medicare PECOS Information:
- PECOS PAC ID: 2163587924
- Enrollment ID: I20090211000776
Medical Identifiers
Medical identifiers for Dr Anton N Dietzen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1063659076 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | 038011314 (Illinois) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | D0089692 (Maryland) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | 036149703 (Illinois) | Secondary |
| 208600000X | Surgery | 125.069633 (Illinois) | Secondary |
| 2081P0010X | Physical Medicine & Rehabilitation - Pediatric Rehabilitation Medicine | 036149703 (Illinois) | Primary |
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. Dr Anton N Dietzen allows following entities to bill medicare on his behalf.
| Provider Name | Central Dupage Physician Group |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1033149844
PECOS PAC ID: 5890696231
Enrollment ID: O20040303000601 |
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| Provider Name | Chicago Health And Physical Therapy Center Sc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1861421950
PECOS PAC ID: 3870596455
Enrollment ID: O20060822000028 |
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| Provider Name | Advanced Rehabilitation Care, Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1285942722
PECOS PAC ID: 8628253259
Enrollment ID: O20110426000464 |
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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. Dr Anton N Dietzen 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 |
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Dr Anton N Dietzen, MD, DC
26w171 Roosevelt Rd,
Wheaton, IL 60187-6002
Ph: (630) 909-7000 | Dr Anton N Dietzen, MD, DC
1750 W Harrison St,
Chicago, IL 60612-3825
Ph: (312) 942-6510 |
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