Pranjal M Agrawal, M.D.
Individual provider Active NPI Internal Medicine Physician · Dixon, IL
NPI 1174723290 · NPPES record last updated Nov 12, 2024
Key facts
- NPI
- 1174723290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 036-118796 (IL)
- Practice address
- 102 S Hennepin Ave
Dixon, IL 61021-3013 - Phone
- (815) 284-7733
- Fax
- (815) 288-1487
- NPI assigned
- Jul 18, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Osf Multi-Specialty Group
Stellar Healthcare PLLC
Practice addresses (Care Compare)
403 E 1St St
Dixon, IL 61021-3116
Phone (815) 288-5531
60 Revere Dr
Suite 575
Northbrook, IL 60062-1577
Phone (847) 920-6896
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- Saint Francis Hospital-Evanston
- Amita Health Resurrection Medical Center
- Osf Saint Katharine Medical Center
- Advocate Lutheran General Hospital
- Saint Joseph Medical Center
- Holy Family Medical Center
- Citadel Care Center-Wilmette
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070823000247 | IL | Practitioner - Internal Medicine | 3577655463 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-118796 | IL | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KSB Medical Group, Inc. | Internal Medicine | Current | Accepting new patients |
| Presence Healthcare Services | Current | Accepting new patients | |
| Tru Impact Healthcare SC | Internal Medicine | Current |
Accepting new patients |
| Stellar Healthcare PLLC | Internal Medicine | Current |
Accepting new patients |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Katherine Shaw Bethea Hospital | Current |
Accepting new patients | |
| Osf Multi-Specialty Group | Internal Medicine | Current |
Accepting new patients |
Locations
62311 Collection Ctr Dr
Chicago, IL 60693
403 E 1st St
Dixon, IL 61021
Phone (815) 285-5629
102 S Hennepin Ave
Dixon, IL 61021
Phone (815) 285-8520
215 E 1st St
Ste 117
Dixon, IL 61021
Phone (815) 285-5900
144 North Ct
Dixon, IL 61021
Phone (815) 284-7733
215 E 1st St
Dixon, IL 61021
Phone (815) 285-5591
215 E 1st St
Ste 111
Dixon, IL 61021
Phone (815) 285-5477
60 Revere Dr
Ste 575
Northbrook, IL 60062
Phone (847) 920-6896
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 036-118796 | IL | |
| Internal Medicine Physician | 207R00000X | 036-118796 | IL | Yes |
Addresses
Primary practice location
102 S Hennepin Ave
Dixon, IL 61021-3013
Mailing address
102 S Hennepin Ave
Dixon, IL 61021-3013
Phone (815) 285-8535
Other practice location 1
403 E 1st St
Dixon, IL 61021-3187
Phone (815) 285-5629
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80020007 | Other | IL | MEDICARE PTAN |
| 036-118796 | Other | IL | ILLINOIS PHYSICIAN & SURG |
| 036118796 | Medicaid | IL | |
| 336-080021 | Other | IL | ILLINOIS CONTROLLED SUBST |
| K40163 | Other | IL | MEDICARE PTAN |
Other providers in Dixon, IL
- Alejandro Aburto-Rodriguez
- Andrew E Accardi
- Corrinne Elizabeth Ackman
- Adult Education Associates
- Advance EMS of Dixon, Inc.
- Luqmaan Ahmed
- Elivia Ahrens
- Gina Aikins
- Darcy Elaine Akins
- Arin N Alberts
All providers in Dixon, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.