Individual provider Active NPI

Angela Intili, M.D.

  • Obstetrics & Gynecology Physician
  • Joliet, IL
National Provider Identifier
1114080033
Registry record updated Feb 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036087434 Issued in IL
Practice address
1415 Essington Rd
Joliet, IL 60435-2873
Phone
(815) 729-2084
Fax
(815) 729-2304
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036087434 IL Primary

Addresses

Primary practice location

1415 Essington Rd
Joliet, IL 60435-2873

Mailing address

1415 Essington Rd
Joliet, IL 60435-2873
Phone (815) 729-2084

Other identifiers 1

IdentifierTypeStateIssuer
036087434MedicaidIL

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
I20080630000370 IL Practitioner - Obstetrics/Gynecology 3476625872 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1415 Essington Rd
Joliet, IL 60435-2873
Phone (815) 729-2084

Hospital & facility affiliations

  • Saint Joseph Medical Center Hospital, Joliet, IL, CCN 140007
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213
  • Morris Hospital & Healthcare Centers Hospital, Morris, IL, CCN 140101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036087434ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vna Health Care CurrentSince Apr 27, 2020 Accepting new patients
Obhg Illinois SC Obstetrics & Gynecology CurrentSince Mar 24, 2020 Accepting new patients
Angela Intili MD LTD Obstetrics & Gynecology CurrentSince Aug 15, 2000 Accepting new patients
Vna Health Care CurrentSince Apr 27, 2020 Accepting new patients
Southwest Aesthetics and Body Sculpture, LLC PastSince Mar 1, 2023 Accepting new patients
Presence Central and Suburban Hospitals Network Past Accepting new patients

Locations

400 N Highland Ave
Aurora, IL 60506

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

333 Madison St
Joliet, IL 60435
Phone (815) 725-7222

333 Madison St
Ste 1024
Joliet, IL 60435
Phone (815) 773-7080

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235692800000",
    "number": "1114080033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 ESSINGTON RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352873",
            "telephone_number": "815-729-2084",
            "fax_number": "815-729-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 ESSINGTON RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352873",
            "telephone_number": "815-729-2084",
            "fax_number": "815-729-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INTILI",
        "first_name": "ANGELA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2009-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036087434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087434",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.