Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jonathan Roderick Dutt, MD

Individual provider Family Medicine Physician · NPI 1497277263

Dr. Jonathan Roderick Dutt, MD is a Family Practice in Decatur, Illinois. Qualified in 2015, 11 years ago. Practices with Board of Trustees of Southern Illinois University, a 142-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
11
Licensed in
IL
In the registry since
2017
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

102 W Kenwood Ave
Decatur, IL 62526-4368
Phone: (217) 545-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 036-151311 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 125.071354 (IL)

Record details

NPI number1497277263
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 12, 2017
Last updated in NPPESMay 4, 2020
Certification dateMay 4, 2020
Mailing addressPo Box 19639, Springfield, IL 62794-9639

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Board Of Trustees Of Southern Illinois University — 142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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