Individual provider Active NPI

John Daniel Attonito, MD

  • Family Medicine Physician
  • Great Lakes, IL
National Provider Identifier
1649800012
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.167685 Issued in IL
Practice address
3420 Illinois Street
Tranquillity Clinic - Special Physicals
Great Lakes, IL 60088
Phone
(847) 688-6755
Fax
(847) 688-2721
NPI assigned
Jan 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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 036.167685 IL Primary

Addresses

Primary practice location

3420 Illinois Street
Tranquillity Clinic - Special Physicals
Great Lakes, IL 60088

Mailing address

3420 Illinois Street
Tranquility Clinic - Special Physicals
Great Lakes, IL 60088
Phone (847) 688-6755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211202000585 FL Order and Referring Only - Family PracticePractitioner - Family Practice 4789074980

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.167685ILMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1649800012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 ILLINOIS STREET",
            "address_2": "TRANQUILITY CLINIC - SPECIAL PHYSICALS",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "60088",
            "telephone_number": "847-688-6755",
            "fax_number": "847-688-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 ILLINOIS STREET",
            "address_2": "TRANQUILLITY CLINIC - SPECIAL PHYSICALS",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "60088",
            "telephone_number": "847-688-6755",
            "fax_number": "847-688-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTONITO",
        "first_name": "JOHN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-24",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.167685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Lakes, IL

Sources for this page

Verify at the official NPI Registry.