Ania Jacqueline Aniol

Individual provider Active NPI Psychiatry Physician · Ottawa, IL

NPI 1689170003 · NPPES record last updated Nov 4, 2022

Key facts

NPI
1689170003
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
036.160145 (IL)
Practice address
1100 E Norris Dr
Ottawa, IL 61350-1604
Phone
(815) 433-3100
NPI assigned
Apr 4, 2018
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Psychiatry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mark David Levine MD Professional Corporation (165 clinicians)

Practice addresses (Care Compare)

2001 Wilshire Blvd
Suite 320
Santa Monica, CA 90403-5683
Phone (855) 501-1004

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240919002731 CA Practitioner - Psychiatry 6608122924 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.160145ILMDPsychiatry Physician

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
Mark David Levine, MD Burlingame PC Psychiatry Current
since Sep 9, 2024
Accepting new patients
Mark David Levine M.D. Professional Corporation Psychiatry Current
since Sep 9, 2024
Accepting new patients

Locations

4553 Glencoe Ave
Ste 315
Marina del Rey, CA 90292

2001 Wilshire Blvd
Ste 320
Santa Monica, CA 90403
Phone (310) 566-2006

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 036.160145 IL Yes

Addresses

Primary practice location

1100 E Norris Dr
Ottawa, IL 61350-1604

Mailing address

3901 Chrysler Dr RM 5-a
Detroit, MI 48201-2167

Other providers in Ottawa, IL

All providers in Ottawa, IL · Psychiatry Physician in Illinois

Sources for this page

Verify at the official NPI Registry.