HOLLY ERIN DALLAS (MD) – Internal Medicine Physician, NPI 1811289309

HOLLY ERIN DALLAS (MD) is a healthcare provider. based in Urbana, Illinois. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 036136967 (IL). The NPI Number for HOLLY ERIN DALLAS (MD) is 1811289309

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
HOLLY ERIN DALLAS (MD)
NPI
1811289309
Phone
(217) 383-6792
Address
611 W. PARK ST.
Enumeration Date
3 May 2011
Last Update Date
19 March 2015

Doctor Profile

Medical School Name
SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2174433106
Graduation Year
2011 (15 years ago)
PAC ID
7416275599
Group Practice PAC ID
2860616299
Professional Enrollment ID
I20150422000213
Address ID
IL618323715DA801XXAVEX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:15State licenses:1Digital endpointsOther names

8,824 INTERNAL MEDICINE in IL

Provider Addresses for HOLLY ERIN DALLAS (MD)

  • 611 W. PARK ST.

    BWPC

    URBANA, IL 618012500

    Phone: (217) 383-6792

    Type: Mailing

  • 1701 W. CURTIS RD

    CHAMPAIGN, IL 618229678

    Phone: (217) 365-6207

    Fax: (217) 365-6380

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-04-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150422000213IInternal MedicineILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860616299View full group profile
NameSpecialtyState
General SurgeryMI
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Physician AssistantIL

Reviews

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Frequently asked questions

What is the registry number for HOLLY ERIN DALLAS (MD)?
The registry entry for HOLLY ERIN DALLAS (MD) shows NPI 1811289309.
Should I treat HOLLY ERIN DALLAS (MD) as an active provider?
Patients and plans typically see HOLLY ERIN DALLAS (MD) as active in the national extract.
Which specialty label fits HOLLY ERIN DALLAS (MD)?
NPPES ties HOLLY ERIN DALLAS (MD) to Internal Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit HOLLY ERIN DALLAS (MD) in Urbana, Illinois?
For routing, start with Urbana, Illinois for HOLLY ERIN DALLAS (MD), then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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