Active NPI
Anthony Christopher Illing, MD
- Diagnostic Radiology Physician
- Brookfield, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 81484
- 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, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124319215 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 81484 | WI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Radiology and Interventional Associates Inc | Diagnostic Radiology | Current | Accepting new patients |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| Northwest Radiology Network P C | Diagnostic Radiology | Current | Accepting new patients |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| The Medical College of Wisconsin, Inc. | Current | 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
- 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.
-
- Internal Medicine Physician
- Menomonee Falls, WI
- NPI 1568787448
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
-
dba Northwest Radiology Network
- Diagnostic Radiology Physician
- Indianapolis, IN
- NPI 1447259338
-
- Diagnostic Radiology Physician
- Columbus, OH
- NPI 1093718496
IN
-
- Diagnostic Radiology Physician
- Silver Spring, MD
- NPI 1396707782
IN
-
- Diagnostic Radiology Physician
- New York, NY
- NPI 1821036807
IN
-
- Durable Medical Equipment & Medical Supplies
- Wauwatosa, WI
- NPI 1154947224
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Delaware, OH
- NPI 1235174327
-
dba OrthoIndy Hospital
- Special Hospital
- Indianapolis, IN
- NPI 1508979683
-
- General Acute Care Hospital
- Mansfield, OH
- NPI 1790837235
-
dba Mansfield Laboratory Services
- Clinical Medical Laboratory
- Mansfield, OH
- NPI 1962888016
Hospital
-
dba Riverside Methodist Hospital
- General Acute Care Hospital
- Columbus, OH
- NPI 1467484972
-
dba OhioHealth Laboratory Systems
- Clinical Medical Laboratory
- Columbus, OH
- NPI 1710916945
Hospital
-
dba Dublin Methodist Hospital
- General Acute Care Hospital
- Dublin, OH
- NPI 1801937008
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": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.