Individual provider Active NPI

Ariella Panos, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1417571449
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.009073 Issued in IL
Practice address
929 W Belmont Ave
Chicago, IL 60657-4408
Phone
(312) 530-0323
NPI assigned
Jun 5, 2020
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.009073 IL Primary

Addresses

Primary practice location

929 W Belmont Ave
Chicago, IL 60657-4408

Mailing address

929 W Belmont Ave
Chicago, IL 60657-4408
Phone (312) 530-0323

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230814002612 IL Practitioner - Physician Assistant 1456713031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rockford Psychiatric Medical Services SCGroup PAC ID 6901089515, 154 clinicians

Practice addresses (Care Compare)

135 N Arlington Heights Rd
Suite 105
Buffalo Grove, IL 60089-8215
Phone (847) 291-8810

1639 N Alpine Rd
Suite 260
Rockford, IL 61107-1481
Phone (815) 395-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Psychiatric Medical Services, S.C. CurrentSince Jan 14, 2026 Accepting new patients
Lurie Children's Medical Group, LLC Past Accepting new patients

Locations

135 N Arlington Heights Rd
Ste 105
Buffalo Grove, IL 60089
Phone (847) 291-8810

1639 N Alpine Rd
Ste 260
Rockford, IL 61107
Phone (815) 395-1500

Organizations & group practices 3

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": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1417571449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574408",
            "telephone_number": "312-530-0323",
            "fax_number": "773-261-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574408",
            "telephone_number": "312-530-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOS",
        "first_name": "ARIELLA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.009073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.