Individual provider Active NPI

Neetha Dhananjaya, M.D.

  • Nephrology Physician
  • Melrose Park, IL
National Provider Identifier
1720058639
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036108649 Issued in IL
Practice address
675 W North Ave Ste 309
Melrose Park, IL 60160-1623
Phone
(312) 654-2744
Fax
(866) 954-5804
NPI assigned
Jan 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 036108649 IL Primary

Addresses

Primary practice location

675 W North Ave Ste 309
Melrose Park, IL 60160-1623

Mailing address

210 S Desplaines St
Chicago, IL 60661-5500
Phone (312) 654-2700

Other identifiers 1

IdentifierTypeStateIssuer
036108649MedicaidIL

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
I20060117000742 IL Practitioner - NephrologyPractitioner - Internal Medicine 1254355324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associates in Nephrology SCGroup PAC ID 9133023963, 52 clinicians

Practice addresses (Care Compare)

3435 W Van Buren St
Chicago, IL 60624-3312
Phone (773) 826-7283

3929 N Central Ave
Suite 4
Chicago, IL 60634-3072
Phone (312) 654-2744

4800 N Kilpatrick Ave
Chicago, IL 60630-1725
Phone (773) 545-3693

4943 W Belmont Ave
Chicago, IL 60641-4332
Phone (773) 685-7500

5645 W Addison St
Chicago, IL 60634-4403
Phone (773) 282-7000

6 N 9TH Ave
Suite 309
Melrose Park, IL 60160-4139
Phone (773) 366-4156

675 W N Ave
Suite 309
Melrose Park, IL 60160-1623
Phone (312) 654-2744

701 W N Ave
Melrose Park, IL 60160-1612
Phone (708) 681-3200

7733 W Grand Ave
Elmwood Park, IL 60707-1820
Phone (708) 452-9200

825 W 35TH St
Chicago, IL 60609-1511
Phone (312) 654-2744

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Nephrology, S.C. Nephrology CurrentSince Jan 1, 2006 Accepting new patients
Loyola University Medical Center Current Accepting new patients

Locations

4026 Paysphere Cir
Chicago, IL 60674

3929 N Central Ave
Ste 4
Chicago, IL 60634
Phone (312) 654-2744

3929 N Central Ave
Chicago, IL 60634
Phone (773) 220-8899

825 W 35th St
Chicago, IL 60609
Phone (773) 890-4330

1111 Superior St
Ste 203
Melrose Park, IL 60160
Phone (708) 938-7464

675 W North Ave
Ste 309
Melrose Park, IL 60160
Phone (312) 654-2744

Interoperability endpoints

  • Direct secure messaging: ndhananjaya18478@direct.acumenmd.com
  • Direct secure messaging: ndhananjaya50718@direct.luhs.org

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.

Hospital & facility affiliations 8

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1720058639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S DESPLAINES ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606615500",
            "telephone_number": "312-654-2700",
            "fax_number": "312-654-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE STE 309",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601623",
            "telephone_number": "312-654-2744",
            "fax_number": "866-954-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHANANJAYA",
        "first_name": "NEETHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036108649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108649",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

Verify at the official NPI Registry.