Individual provider Active NPI

Anthony Christopher Illing, MD

  • Diagnostic Radiology Physician
  • Brookfield, WI
National Provider Identifier
1124319215
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
81484 Issued in WI
Practice address
1905 N Calhoun Rd
Brookfield, WI 53005-5005
Phone
(262) 754-8000
Fax
(262) 780-3396
NPI assigned
Apr 25, 2011
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01076842A IN
Diagnostic Radiology Physician 2085R0202X 81484 WI Primary

Addresses

Primary practice location

1905 N Calhoun Rd
Brookfield, WI 53005-5005

Mailing address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-2060

Other practice location 1

4455 S 108th St
Greenfield, WI 53228-2504
Phone (414) 427-5310

Other practice location 2

W180N8085 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 257-3060

Other practice location 3

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-2060

Other identifiers 1

IdentifierTypeStateIssuer
1124319215MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170622002359 IN Practitioner - Diagnostic Radiology 6608010962 Reassigns benefits to 5 organizations
I20230324001019 WI Practitioner - Diagnostic Radiology 6608010962 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Indiana University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Radiology Network P CGroup PAC ID 1557331261, 22 clinicians
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians
Riverside Radiology and Interventional Associates IncGroup PAC ID 8729976964, 251 clinicians

Practice addresses (Care Compare)

10603 N Meridian St
Northwest Radiology Network
Indianapolis, IN 46290-1055
Phone (317) 972-9669

11380 Illinois St
Suite 110
Carmel, IN 46032-9841
Phone (317) 328-3747

1155 N Mayfair Rd
FL 2
Milwaukee, WI 53226-3462
Phone (414) 955-4263

120 Avon Market PL
Suite 110
Avon, IN 46123-6021
Phone (317) 715-9977

13225 N Meridian St
Indiana Spine Group
Carmel, IN 46032-5480
Phone (317) 228-7000

14300 E
138TH Suite C BLDG B
Fishers, IN 46037-0051
Phone (317) 875-8655

14300 E 138TH St BLDG B
Central Indiana Orthopedics
Fishers, IN 46037-0051
Phone (800) 622-6575

14457 Marlin CV
Fort Wayne, IN 46814-9614
Phone (614) 340-7740

2315 E Moreland Blvd
Waukesha, WI 53186-2939
Phone (262) 532-5700

288 E 175TH St
Orthoindy Westfield
Westfield, IN 46074-8934
Phone (317) 275-6140

3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-7300

3212 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 334-6165

4196 Alderborough Way
Zionsville, IN 46077-7861
Phone (614) 340-7740

4805 S Moorland Rd
New Berlin, WI 53151-7401
Phone (262) 798-7200

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060

W180 N8065 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000

W180N8071 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 253-2700

W180N8085 Town Hall Rd
Suite 301
Menomonee Falls, WI 53051-3518
Phone (262) 257-3200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81484WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Radiology and Interventional Associates Inc Diagnostic Radiology CurrentSince Apr 1, 2023 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Apr 10, 2023 Accepting new patients
Northwest Radiology Network P C Diagnostic Radiology CurrentSince Aug 1, 2017 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Apr 10, 2023 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Apr 1, 2023 Accepting new patients

Locations (25 of 26)

2015 Jackson St
Anderson, IN 46016
Phone (765) 646-8243

10603 N Meridian St
Carmel, IN 46290
Phone (317) 415-6050

11380 Illinois St
Ste 110
Carmel, IN 46032
Phone (317) 328-3747

11450 N Meridian St
Ste 100
Carmel, IN 46032
Phone (317) 689-7850

13225 N Meridian St
Carmel, IN 46032
Phone (317) 715-4863

13250 Hazel Dell Pkwy
Carmel, IN 46033
Phone (317) 415-6900

14300 E 138th
Ste C
Fishers, IN 46037
Phone (317) 875-8655

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

5901 Technology Center Dr
Indianapolis, IN 46278
Phone (317) 328-4777

8050 Township Line Rd
Indianapolis, IN 46260
Phone (317) 338-2442

8301 Harcourt Rd
Indianapolis, IN 46260
Phone (317) 415-6760

8550 Naab Rd
Ste 300
Indianapolis, IN 46260
Phone (317) 338-9590

8902 N Meridian St
Ste 103
Indianapolis, IN 46260
Phone (317) 580-3100

9240 N Meridian St
Ste 160B
Indianapolis, IN 46260
Phone (317) 415-6230

2605 N Lebanon St
Lebanon, IN 46052
Phone (765) 485-8000

911 N Shelby St
Salem, IN 47167
Phone (812) 883-5881

1650 W Oak St
Ste 100
Zionsville, IN 46077
Phone (317) 873-8800

6085 Heartland Dr
Zionsville, IN 46077
Phone (317) 768-2100

1905 N Calhoun Rd
Brookfield, WI 53005
Phone (262) 333-0040

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

4455 S 108th St
Milwaukee, WI 53228
Phone (414) 409-7593

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Interoperability endpoints

  • Direct secure messaging: ailling617615@direct.froedtert.com

Organizations & group practices 8

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.

Hospital & facility affiliations 7

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": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1124319215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-2060",
            "fax_number": "414-259-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 N CALHOUN RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055005",
            "telephone_number": "262-754-8000",
            "fax_number": "262-780-3396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4455 S 108th St",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "WI",
            "postal_code": "532282504",
            "country_code": "US",
            "telephone_number": "414-427-5310",
            "fax_number": "414-427-5311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "W180N8085 Town Hall Rd",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530513518",
            "country_code": "US",
            "telephone_number": "262-257-3060",
            "fax_number": "262-518-5052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-2060",
            "fax_number": "414-259-9290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILLING",
        "first_name": "ANTHONY",
        "middle_name": "CHRISTOPHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-25",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01076842A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "81484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124319215",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.