Individual provider Active NPI

Catherine Anichini, MD

  • Family Medicine Physician
  • Berwyn, IL
National Provider Identifier
1023040904
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-085273 Issued in IL
Practice address
6326 Cermak Rd
Berwyn, IL 60402
Phone
(708) 303-9234
Fax
(305) 698-6536
NPI assigned
Jul 7, 2006
Last updated
Jun 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-085273 IL Primary

Addresses

Primary practice location

6326 Cermak Rd
Berwyn, IL 60402

Mailing address

6326 Cermak Rd
Berwyn, IL 60402-2304
Phone (708) 303-9234

Other identifiers 1

IdentifierTypeStateIssuer
036085273MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100526000817 IL Practitioner - Family Practice 2062541253 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-085273ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Little Company of Mary Affiliated Services Inc CurrentSince Dec 8, 2010 Accepting new patients
Little Company of Mary Affiliated Services Inc CurrentSince Dec 8, 2010 Accepting new patients
PMR Illinois Holding, LLC CurrentSince Jan 1, 2022 Accepting new patients
West Suburban Medical Center Family Medicine Past Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

6326 Cermak Rd
Berwyn, IL 60402
Phone (708) 303-9234

2231 E 95th St
Chicago, IL 60617
Phone (773) 768-7700

2734 W 87th St
Chicago, IL 60652
Phone (773) 918-4700

2800 W 87th St
Chicago, IL 60652
Phone (312) 423-4200

2800 W 95th St
Evergreen Pk, IL 60805
Phone (708) 229-5104

5660 W 95th St
Oak Lawn, IL 60453
Phone (708) 499-2273

5660 W 95th St
Ste 1
Oak Lawn, IL 60453
Phone (708) 499-2273

6101 W 95th St
Oak Lawn, IL 60453
Phone (708) 261-0831

12450 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 448-1207

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1023040904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6326 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022304",
            "telephone_number": "708-303-9234",
            "fax_number": "305-698-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6326 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "60402",
            "telephone_number": "708-303-9234",
            "fax_number": "305-698-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANICHINI",
        "first_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-085273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085273",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.