Priyanka Gauravi, M.D.
Individual provider Active NPI Internal Medicine Physician · Chicago, IL
NPI 1740410869 · NPPES record last updated Jul 16, 2015
Key facts
- NPI
- 1740410869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 125055939 (IL)
- Practice address
- 4646 N Marine Dr
Chicago, IL 60640-5759 - Phone
- (773) 878-8700
- NPI assigned
- Jul 23, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Endocrinology
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Morrison Community Hospital District
Practice addresses (Care Compare)
303 N Jackson St
Morrison, IL 61270-3042
Phone (815) 772-4003
Hospital & facility affiliations
- Morrison Community Hospital
- CGH Medical Center
- Mercyone Clinton Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150813009323 | IL | Practitioner - Endocrinology | 2961636907 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125055939 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morrison Community Hospital District | Current | Accepting new patients | |
| Morrison Community Hospital District | Current |
Accepting new patients | |
| Morrison Community Hospital District | Current |
Accepting new patients | |
| Morrison Community Hospital District | Current | Accepting new patients | |
| Morrison Community Hospital District | Past | Accepting new patients |
Locations
657 W Lincolnway
Morrison, IL 61270
Phone (815) 772-4003
303 N Jackson St
Morrison, IL 61270
Phone (815) 772-4003
Interoperability endpoints
- priyankagauravi@mchospital.medalliesdirect.net
- pgauravi@mchstaff.securechart.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125055939 | IL | Yes |
Addresses
Primary practice location
4646 N Marine Dr
Chicago, IL 60640-5759
Mailing address
708 Milnes Dr
Morrison, IL 61270-2065
Phone (847) 702-1742
Other providers in Chicago, IL
- Jeffrey I. Gaule
- Danielle Gault
- Catherine Gaumer
- Dipika Gaur
- Paul Gaura
- Beatrice Meda Gaurean
- Eric Gausche
- Crystal Gausden
- Andrew Gause
- Janay Gause
All providers in Chicago, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.