Adam T Angelilli, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036.122065 Issued in IL

Practice address

1010 W Fairway Dr
2ND Floor (Pediatrics)
Freeport, IL 61032-6600

Phone

(815) 599-7755

Fax

(815) 599-7627

NPI assigned

Sep 3, 2008

Last updated

Jun 1, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Freeport Regional Health Care Foundation

  dba FHN

  • Family Medicine Physician
  • Freeport, IL
  • NPI 1457337016
  Medicare reassignment NPD

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1144478173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W FAIRWAY DR",
            "address_2": "2ND FLOOR (PEDIATRICS)",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326600",
            "telephone_number": "815-599-7755",
            "fax_number": "815-599-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W FAIRWAY DR",
            "address_2": "2ND FLOOR (PEDIATRICS)",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326600",
            "telephone_number": "815-599-7755",
            "fax_number": "815-599-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELILLI",
        "first_name": "ADAM",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.122065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Freeport, IL
• Providers in Freeport, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.