Active NPI
Nandini Upadhyay, MD
- Pediatrics Physician
- Gurnee, IL
National Provider Identifier
1235123308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036072633
- Practice address
- 15 Tower CT
Ste 100
Gurnee, IL 60031-3336 - Phone
- (847) 244-1375
- Fax
- (847) 244-1002
- NPI assigned
- Sep 6, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036072633 | IL | Primary |
Addresses
Primary practice location
15 Tower CT
Ste 100
Gurnee, IL 60031-3336
Mailing address
15 Tower CT
Ste 100
Gurnee, IL 60031-3336
Phone (847) 244-1375
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0360372633 | Medicaid | IL |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nupadhyay206591@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https//EpicFHIR.aurora.org/FIHR/MYAURORA/api/GHIR/DISTU2 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- nupadhyay206591@direct.myadvocateaurora.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1235123308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 TOWER CT",
"address_2": "STE 100",
"city": "GURNEE",
"state": "IL",
"postal_code": "600313336",
"telephone_number": "847-244-1375",
"fax_number": "847-244-1002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 TOWER CT",
"address_2": "STE 100",
"city": "GURNEE",
"state": "IL",
"postal_code": "600313336",
"telephone_number": "847-244-1375",
"fax_number": "847-244-1002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UPADHYAY",
"first_name": "NANDINI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-06",
"last_updated": "2021-12-06",
"certification_date": "2021-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036072633",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0360372633",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nupadhyay206591@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "15 Tower Ct",
"address_2": "Ste 100",
"city": "Gurnee",
"state": "IL",
"country_code": "US",
"postal_code": "600313336",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https//EpicFHIR.aurora.org/FIHR/MYAURORA/api/GHIR/DISTU2",
"affiliation": "N",
"address_1": "15 Tower Ct",
"address_2": "Ste 100",
"city": "Gurnee",
"state": "IL",
"country_code": "US",
"postal_code": "600313336",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Gurnee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.