Individual provider Active NPI

Aditi Puri, MD

  • Internal Medicine Physician
  • Berwyn, IL
National Provider Identifier
1578882221
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036143028 Issued in IL
Practice address
3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone
(708) 783-6566
Fax
(708) 783-6567
NPI assigned
May 20, 2010
Last updated
May 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036143028 IL Primary

Addresses

Primary practice location

3249 Oak Park Ave
Berwyn, IL 60402-3429

Mailing address

3249 Oak Park Ave
Berwyn, IL 60402-3429

Other identifiers 1

IdentifierTypeStateIssuer
1028219280001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apuri152540@direct.luhs.org Direct GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION

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
I20170526000060 IL Practitioner - Internal Medicine 2769622265 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Alabama School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola Medical Group LLCGroup PAC ID 6305109547, 124 clinicians

Practice addresses (Care Compare)

3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-0700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036143028ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gottlieb Community Health Services Corporation CurrentSince Apr 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2017 Accepting new patients
Loyola Medical Group LLC CurrentSince Aug 16, 2022 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2017 Accepting new patients
Gottlieb Community Health Services Corporation CurrentSince Apr 1, 2022 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

3231 Euclid Ave
Ste 407
Berwyn, IL 60402
Phone (708) 783-7430

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

Dept 5777
Carol Stream, IL 60122

251 E Huron St
Chicago, IL 60611

125 N La Grange Rd
La Grange, IL 60525
Phone (708) 354-4900

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

3722 Harlem Ave
Ste LL34
Riverside, IL 60546
Phone (708) 783-6566

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1578882221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429",
            "telephone_number": "708-783-6566",
            "fax_number": "708-783-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURI",
        "first_name": "ADITI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-20",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036143028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028219280001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apuri152540@direct.luhs.org",
            "affiliation": "Y",
            "affiliationName": "GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3249 Oak Park Ave",
            "city": "Berwyn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604023429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.