Anil K Gulati, MD
Individual provider Active NPI Neurology Physician · Chicago, IL
NPI 1003899428 · NPPES record last updated Feb 11, 2016
Key facts
- NPI
- 1003899428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- 036-079542 (IL)
- Practice address
- 2850 S Wabash Ave
Suite 102
Chicago, IL 60616-2955 - Phone
- (312) 496-3488
- Fax
- (844) 235-6160
- NPI assigned
- Nov 21, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 28
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Neurology
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Board of Trustees of the University of Illinois
Practice addresses (Care Compare)
1740 W Taylor St
Chicago, IL 60612-7232
1855 W Taylor St
Chicago, IL 60612-7242
Phone (312) 996-6590
2850 S Wabash Ave
Suite 102
Chicago, IL 60616-2491
Phone (312) 496-3488
Hospital & facility affiliations
- Jackson Park Hospital
- South Shore Hospital
- University of Illinois Hospital and Clinics
- Advocate Trinity Hospital
- Advocate Christ Hospital & Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041123000018 | IL | Practitioner - Neurology |
6901861657 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-079542 | IL | MD | Neurology Physician |
Practice roles (5 of 10)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| Jackson Park Hospital Foundation | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current |
Accepting new patients | |
| Southeast Chicago Neurology Associates SC | Neurology | Current |
Accepting new patients |
| The Board of Trustees of the University of Illinois | Current |
Accepting new patients |
Locations
7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290
2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153
1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582
2850 S Wabash Ave
Ste 102
Chicago, IL 60616
Phone (312) 225-6080
Networks
- devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
- IL HMO C-SNP
- devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
- IL PPO Downstate
- devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
Interoperability endpoints
- anilguiati@jph.medalliesdirect.net
- agulati17084@uihealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 036-079542 | IL | Yes |
Addresses
Primary practice location
2850 S Wabash Ave
Suite 102
Chicago, IL 60616-2955
Mailing address
2850 S Wabash Ave
Suite 102
Chicago, IL 60616-2955
Phone (312) 496-3488
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00180938 | Other | RR MEDICARE | |
| 03607952 | Medicaid | IL | |
| 1606264 | Other | BC BS OF IL |
NPI Registry JSON
{
"created_epoch": "1132531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455148800000",
"number": "1003899428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2850 S WABASH AVE",
"address_2": "SUITE 102",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606162955",
"telephone_number": "312-496-3488",
"fax_number": "844-235-6160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2850 S WABASH AVE",
"address_2": "SUITE 102",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606162955",
"telephone_number": "312-496-3488",
"fax_number": "844-235-6160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULATI",
"first_name": "ANIL",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-21",
"last_updated": "2016-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": "036-079542",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00180938",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03607952",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF IL",
"identifier": "1606264",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
- Dondee Gujilde
- Sapna R Gujja
- Amandeep Gujral
- Sabeena Gul
- Brisa Gulari-Jones
- Reeti Kiran Gulati
- Shawn Gulati
- Karan Gulaya
- Barbara B Gulczynski
- Shan Guleria
All providers in Chicago, IL · Neurology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.