Individual provider Active NPI

Deepak Mital, M.D.

  • Transplant Surgery Physician
  • Oak Lawn, IL
National Provider Identifier
1720024219
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transplant Surgery PhysicianTaxonomy code 204F00000X
License
036-087116 Issued in IL
Practice address
4400 W 95TH St Ste 112
Oak Lawn, IL 60453-2657
Phone
(708) 684-7100
Fax
(708) 684-7130
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X 036-087116 IL Primary

Addresses

Primary practice location

4400 W 95TH St Ste 112
Oak Lawn, IL 60453-2657

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

1725 W Harrison St
Suite 161
Chicago, IL 60612-3841
Phone (312) 942-4252

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dmital206082@direct.myadvocateaurora.org
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20081101000093 IL Practitioner - General Surgery 7315006673 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1740 W Taylor St
Chicago, IL 60612-7232

1801 W Taylor St
Chicago, IL 60612-4795

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-087116ILMDTransplant Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Transplant Surgery CurrentSince Sep 27, 2023 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Sep 27, 2023 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jun 1, 2013 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jun 1, 2013 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

29373 Network Pl
Chicago, IL 60673

1801 W Taylor St
#3F
Chicago, IL 60612
Phone (312) 355-4300

1725 W Harrison St
Ste 161
Chicago, IL 60612
Phone (312) 942-4252

75 Remittance Dr
Dept 1611
Chicago, IL 60675

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

4400 W 95th St
Ste 207
Oak Lawn, IL 60453
Phone (708) 346-5340

4400 W 95th St
Ste 112
Oak Lawn, IL 60453
Phone (708) 684-7100

10811 W 143rd St
Ste 100
Orland Park, IL 60467
Phone (708) 460-2500

420 NE Glen Oak Ave
Ste 401
Peoria, IL 61603
Phone (309) 624-9259

Interoperability endpoints

  • Direct secure messaging: dmital154913@uihealth.direct-ci.com

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 and National Provider Directory roles.

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1720024219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST STE 112",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532657",
            "telephone_number": "708-684-7100",
            "fax_number": "708-684-7130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 W Harrison St",
            "address_2": "Suite 161",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123841",
            "country_code": "US",
            "telephone_number": "312-942-4252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITAL",
        "first_name": "DEEPAK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "IL",
            "license": "036-087116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmital206082@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "4400 W 95th St Ste 112",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532657",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4400 W 95th St Ste 112",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.