Individual provider Active NPI

Audrey Geannopoulos, M.D.

  • Internal Medicine Physician
  • Naperville, IL
National Provider Identifier
1124282546
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036081052 Issued in IL
Practice address
1020 E Ogden Ave
115
Naperville, IL 60563-8609
Phone
(630) 717-8707
NPI assigned
Jul 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036081052 IL Primary

Addresses

Primary practice location

1020 E Ogden Ave
115
Naperville, IL 60563-8609

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 1

IdentifierTypeStateIssuer
036081052MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ageannopoulos11638@direct.edward.org
Direct Messaging Address ageannopoulos11638@dulyhealthandcare.direct-ci.com

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
I20100603000633 IL Practitioner - Internal Medicine 7315076155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, San Francisco School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

1020 E Ogden Ave
Suite 115
Naperville, IL 60563-8610
Phone (630) 717-8707

Hospital & facility affiliations

  • Residential Home Health Home health agency, Lisle, IL, CCN 147568
  • Edward Hospital Hospital, Naperville, IL, CCN 140231
  • Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince May 1, 2010 Accepting new patients
Dupage Medical Group LTD CurrentSince May 1, 2010 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

1020 E Ogden Ave
Ste 115
Naperville, IL 60563
Phone (630) 355-1300

1020 E Ogden Ave
Naperville, IL 60563
Phone (630) 369-8902

Interoperability endpoints

  • Direct secure messaging: ageannopoulos11638@dulyhealthandcare.direct-ci.com
  • Direct secure messaging: ageannopoulos11638@direct.edward.org

Organizations & group practices 2

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 3

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": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1124282546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 E OGDEN AVE",
            "address_2": "115",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638609",
            "telephone_number": "630-717-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEANNOPOULOS",
        "first_name": "AUDREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-15",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036081052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081052",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ageannopoulos11638@direct.edward.org",
            "affiliation": "N",
            "address_1": "1020 E Ogden Ave",
            "address_2": "115",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605638609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ageannopoulos11638@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "1020 E Ogden Ave",
            "address_2": "115",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605638609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.