Individual provider Active NPI

Abhista Vallabhaneni, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1306102314
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036137717 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Apr 3, 2012
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036137717 MI
Emergency Medicine Physician 207P00000X 036137717 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

5645 W Addison St
Chicago, IL 60634-4403
Phone (773) 282-7000

Other practice location 1

5645 W Addison St
Chicago, IL 60634-4403
Phone (773) 282-7000

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
I20150903000706 IL Practitioner - Emergency Medicine 6800102930 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036137717MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community First Healthcare of Illinois, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Osf Multi-Specialty Group CurrentSince Sep 1, 2021 Accepting new patients
Osf Healthcare System CurrentSince Mar 1, 2020 Accepting new patients
Osf Healthcare System CurrentSince Mar 1, 2020 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Healthcare System Current Accepting new patients
Community First Healthcare of Illinois, Inc. Emergency Medicine CurrentSince Jan 1, 2017 Accepting new patients
Mea Chicago PC Emergency Medicine CurrentSince Jun 1, 2019 Accepting new patients
Osf Multi-Specialty Group CurrentSince Sep 1, 2021 Accepting new patients

Locations

2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

5645 W Addison St
Ste 301
Chicago, IL 60634
Phone (773) 736-4553

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1306102314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5645 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344403",
            "telephone_number": "773-282-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5645 W Addison St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606344403",
            "country_code": "US",
            "telephone_number": "773-282-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLABHANENI",
        "first_name": "ABHISTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "036137717",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036137717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.