Individual provider Active NPI

Ana D Gavrilovici, M.D.

  • Family Medicine Physician
  • Lincolnwood, IL
National Provider Identifier
1144220864
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-099746 Issued in IL
Practice address
6400 N Keating Ave
Lincolnwood, IL 60712-3411
Phone
(847) 568-1500
Fax
(847) 568-1511
NPI assigned
Jul 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-099746 IL Primary

Addresses

Primary practice location

6400 N Keating Ave
Lincolnwood, IL 60712-3411

Mailing address

6400 N Keating Ave
Lincolnwood, IL 60712-3411
Phone (847) 568-1500

Other identifiers 1

IdentifierTypeStateIssuer
036099746MedicaidIL

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
I20080709000666 IL Practitioner - Family Practice 4688746571 Practice locations: Chicago, IL; Evanston, IL; Lincolnwood, IL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1996
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6400 N Keating Ave
Lincolnwood, IL 60712-3411
Phone (847) 568-1500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions14
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-099746ILMDFamily Medicine Physician

Hospital & facility affiliations 5

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1144220864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 N KEATING AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607123411",
            "telephone_number": "847-568-1500",
            "fax_number": "847-568-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 N KEATING AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607123411",
            "telephone_number": "847-568-1500",
            "fax_number": "847-568-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVRILOVICI",
        "first_name": "ANA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-099746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099746",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnwood, IL

Sources for this page

Verify at the official NPI Registry.