Individual provider Active NPI

Fathima Fijula Palot Manzil, M.B.B.S.

  • Nuclear Medicine Physician
  • Chicago, IL
National Provider Identifier
1467762997
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine PhysicianTaxonomy code 207U00000X
License
036166834 Issued in IL
Practice address
1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone
(312) 942-5000
NPI assigned
Oct 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X E-12123 AR
Diagnostic Radiology Physician 2085R0202X 036166834 IL
Nuclear Medicine Physician 207U00000X 036166834 IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy
Chicago, IL 60612-3833

Mailing address

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 942-5000

Other practice location 1

4301 W Markham St # 556
Little Rock, AR 72205-7101
Phone (501) 686-6661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200731000230 AR Practitioner - Nuclear Medicine 0648416693 Reassigns benefits to 2 organizations
I20240617002687 IL Practitioner - Nuclear MedicinePractitioner - Diagnostic Radiology 0648416693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nuclear MedicineAlso: Diagnostic Radiology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 563-4270

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119
  • Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-12123ARMDNuclear Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Diagnostic Radiology CurrentSince Jun 30, 2024 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 27, 2020 Accepting new patients
University of Arkansas for Medical Sciences Diagnostic Radiology Current Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
Rush University Medical Center Diagnostic Radiology CurrentSince Jun 30, 2024 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 27, 2020 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 27, 2020 Accepting new patients

Locations

4301 W Markham St
#556
Little Rock, AR 72205
Phone (501) 296-1095

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1467762997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 556",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-6661",
            "fax_number": "501-526-6525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALOT MANZIL",
        "first_name": "FATHIMA",
        "middle_name": "FIJULA",
        "credential": "M.B.B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-18",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "AR",
            "license": "E-12123",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036166834",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "IL",
            "license": "036166834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.