Individual provider Active NPI

Ravinder Dhillon, M. D.

  • Emergency Medicine Physician
  • Melrose Park, IL
National Provider Identifier
1679643902
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036094989 Issued in IL
Practice address
701 W North Ave
Melrose Park, IL 60160-1612
Phone
(708) 681-3200
Fax
(708) 681-5228
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036094989 IL Primary

Addresses

Primary practice location

701 W North Ave
Melrose Park, IL 60160-1612

Mailing address

33786 Treasury Ctr
Chicago, IL 60694-3700
Phone (708) 460-7444

Other identifiers 2

IdentifierTypeStateIssuer
01623845OtherILBLUE CROSS BLUESHIELD I D
036094989MedicaidIL

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
I20091103000320 IL Practitioner - Emergency Medicine 5597803080 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
R Franklin University of Med & Sci/Chicago Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Medical Center, AledoGroup PAC ID 7315190436, 17 clinicians

Practice addresses (Care Compare)

409 NW 9TH Ave
Aledo, IL 61231-1258
Phone (309) 582-3701

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Center, Aledo CurrentSince Jun 9, 2018 Accepting new patients
Genesis Medical Center, Aledo CurrentSince Jun 9, 2018 Accepting new patients
Empact Emergency Physicians LLC Past Accepting new patients
Northern Illinois Emergency & Occp Med Spec Past Accepting new patients

Locations

1007 NW 3rd St
Aledo, IL 61231
Phone (309) 582-3701

409 NW 9th Ave
Aledo, IL 61231
Phone (309) 582-2227

Organizations & group practices 4

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 2

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1679643902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33786 TREASURY CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606943700",
            "telephone_number": "708-460-7444",
            "fax_number": "708-460-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601612",
            "telephone_number": "708-681-3200",
            "fax_number": "708-681-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHILLON",
        "first_name": "RAVINDER",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036094989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUESHIELD I D",
            "identifier": "01623845",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094989",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

Verify at the official NPI Registry.