Anish Pravin Pithadia, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-116564 Issued in IL

Practice address

3633 W Lake Ave Ste 108
Glenview, IL 60026-5801

Phone

(847) 510-2805

Fax

(847) 510-2806

NPI assigned

Mar 23, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2026 through Jan 1, 2028

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 and National Provider Directory roles.

• Pioneer Concierge Medicine, PLLC

  • Family Medicine Physician
  • Glenview, IL
  • NPI 1417676891
  NPD Authorized official
• Park Primary Care LTD

  • General Practice Physician
  • Evergreen Park, IL
  • NPI 1891984068
  NPD (past)
• Presence Healthcare Services

  dba Presence Medical Group

  • Multi-Specialty Clinic/Center
  • Elk Grove Village, IL
  • NPI 1932216819

  Family Medicine

  NPD (past)
• Resurrection Services

  dba Resurrection Ambulatory Care Services

  • Clinic/Center
  • Chicago, IL
  • NPI 1326277005
  NPD (past)
• Resurrection Services

  dba Resurrection Immediate Care Center Norridge

  • Multi-Specialty Clinic/Center
  • Norridge, IL
  • NPI 1922121599
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1417074774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE STE 108",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265801",
            "telephone_number": "847-510-2805",
            "fax_number": "847-510-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE STE 108",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265801",
            "telephone_number": "847-510-2805",
            "fax_number": "847-510-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITHADIA",
        "first_name": "ANISH",
        "middle_name": "PRAVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-116564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP",
            "identifier": "1619414",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3633309286030501",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Joseph Pinkston, DDS
• Azuli M. Pinon
• Pioneer Concierge Medicine, PLLC
• Crystal Ann Piper, COTA/L
• Charles Nicholas Pistorio, PH.D.
• Brittany Placek, DC
• Donnamarie Placio, MPT
• Mary Marsha Planta-Yap
• Toni Ann Pliskin, LCSW
• Mollie Plotkin

• Family Medicine Physician in Glenview, IL
• Providers in Glenview, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.