Individual provider Active NPI

Anali Khalil

  • Social Worker
  • Dyer, IN
National Provider Identifier
1528507977
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
33008034A Issued in IN
Practice address
9853 Wabash St
Dyer, IN 46311-7733
Phone
(219) 440-2627
NPI assigned
Feb 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33008034A IN Primary

Addresses

Primary practice location

9853 Wabash St
Dyer, IN 46311-7733

Mailing address

9853 Wabash St
Dyer, IN 46311-7733
Phone (219) 440-2627

Other practice location 1

1867 N Maud Ave
Chicago, IL 60614-4905
Phone (773) 296-9433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
33008034AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Wellness Lab LLC CurrentSince Jan 22, 2023 Accepting new patients
The Wellness Lab LLC CurrentSince Jan 22, 2023 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1528507977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9853 WABASH ST",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463117733",
            "telephone_number": "219-440-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9853 WABASH ST",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463117733",
            "telephone_number": "219-440-2627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1867 N Maud Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606144905",
            "country_code": "US",
            "telephone_number": "773-296-9433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHALIL",
        "first_name": "ANALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-17",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33008034A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.