Individual ProviderDina PavilonisFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address965 Lake St, Oak Park, IL 60301-1292(708) 383-0400PECOS EnrollmentBased on the most recent information from CMS, provider Dina Pavilonis is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1316252489Provider TypeIndividualFull NamePavilonis, DinaCredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date8/13/2010Last Updated6/16/2014Contact InformationPractice LocationPractice Address965 Lake St, Oak Park, IL 60301-1292Phone(708) 383-0400FaxUnlisted FaxMailing LocationMailing Address965 Lake St, Attn: Tracy Briones, Oak Park, IL 60301-1292Phone(708) 383-0400Fax(708) 383-4314Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense036131456IllinoisProvider IdentifiersIDDescriptionIssuerID125058764DescriptionOtherIssuerLICENSEIllinois