Individual provider Active NPI

Vishwanath Agrawal, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Chicago, IL
National Provider Identifier
1083637771
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
036-085966 Issued in IL
Practice address
1901 W Harrison St
Chicago, IL 60612-3714
Phone
(312) 864-4063
Fax
(312) 864-9943
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-085966 IL
Neonatal-Perinatal Medicine Physician 2080N0001X 036-085966 IL Primary

Addresses

Primary practice location

1901 W Harrison St
Chicago, IL 60612-3714

Mailing address

752 Century Farm LN
Naperville, IL 60563-2586
Phone (630) 548-2748

Other practice location 1

2233 W Division St
Chicago, IL 60622-8151
Phone (312) 770-2000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address vagrawal@direct.ccprovider.org Direct Cook County
Direct Messaging Address vagrawal29204@ce-direct.presencehealth.org PRESENCE HEALTHCARE SERVICES

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
I20110308001029 IL Practitioner - Pediatric MedicinePractitioner - Other (Physician) 0648452995 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-085966ILMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Nov 4, 2010 Accepting new patients
Presence Healthcare Services Current Accepting new patients
Cook County Current Accepting new patients
Cook County Pediatrics CurrentSince Nov 4, 2010 Accepting new patients

Locations

62311 Collection Ctr Dr
Chicago, IL 60693

7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977

2020 W Harrison St
Chicago, IL 60612
Phone (312) 572-4500

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1083637771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 CENTURY FARM LN",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632586",
            "telephone_number": "630-548-2748",
            "fax_number": "312-964-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-4063",
            "fax_number": "312-864-9943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2233 W Division St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606228151",
            "country_code": "US",
            "telephone_number": "312-770-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGRAWAL",
        "first_name": "VISHWANATH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-085966",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IL",
            "license": "036-085966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vagrawal@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vagrawal29204@ce-direct.presencehealth.org",
            "affiliation": "Y",
            "affiliationName": "PRESENCE HEALTHCARE SERVICES",
            "address_1": "2233 W Division St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606228151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.