Individual provider Active NPI

Pallavi Rangan, MBBS

  • Anatomic Pathology & Clinical Pathology Physician
  • Maywood, IL
National Provider Identifier
1659102713
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
125.084977 Issued in IL
Practice address
2160 S 1St Ave BLDG 110
Maywood, IL 60153-3328
Phone
(708) 327-2547
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Pathology) Physician 207ZH0000X 125.084977 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 125084977 IL
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 125.084977 IL Primary

Addresses

Primary practice location

2160 S 1St Ave BLDG 110
Maywood, IL 60153-3328

Mailing address

2640 N Avondale Ave Unit G
Chicago, IL 60647-6401
Phone (551) 349-5074

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
I20241127002408 IL Order and Referring Only - Hematology/OncologyPractitioner - Hematology/Oncology 6002341070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125.084977ILMDAnatomic Pathology & Clinical Pathology Physician
125084977ILMDAnatomic Pathology & Clinical Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1659102713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 N AVONDALE AVE UNIT G",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606476401",
            "telephone_number": "551-349-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE BLDG 110",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-327-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANGAN",
        "first_name": "PALLAVI",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "IL",
            "license": "125.084977",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "125084977",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "125.084977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.