Individual provider Active NPI

Michael David Santilli, DO

  • Family Medicine Physician
  • Countryside, IL
National Provider Identifier
1497768865
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36103975 Issued in IL
Practice address
7345 Prescott LN
Countryside, IL 60525-5037
Phone
(708) 354-9405
Fax
(708) 354-9140
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36103975 IL Primary

Addresses

Primary practice location

7345 Prescott LN
Countryside, IL 60525-5037

Mailing address

7345 Prescott LN
Countryside, IL 60525-5037
Phone (708) 354-9405

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
I20100317000581 IL Practitioner - Family Practice 5496880395 Reassigns benefits to 1 organization
Practice locations: Countryside, IL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7345 Prescott LN
Countryside, IL 60525-5037
Phone (708) 354-9405

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
26.05 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
86.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36103975ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Midwest Health Family Medicine CurrentSince Feb 1, 2010 Accepting new patients
Adventist Midwest Health Current Accepting new patients

Locations

5201 Willow Springs Rd
La Grange Highlands, IL 60525
Phone (630) 323-5214

5101 Willow Springs Rd
Lagrange Hlds, IL 60525
Phone (708) 245-4073

Organizations & group practices 2

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 10

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1497768865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7345 PRESCOTT LN",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605255037",
            "telephone_number": "708-354-9405",
            "fax_number": "708-354-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7345 PRESCOTT LN",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605255037",
            "telephone_number": "708-354-9405",
            "fax_number": "708-354-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTILLI",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36103975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Countryside, IL

Sources for this page

Verify at the official NPI Registry.