Nani Internal Med LLC

Key facts

NPI

1740765700

Entity type

Organization (NPI type 2)

Primary specialty

Internal Medicine Physician 207R00000X

Legal business name

NANI INTERNAL MED LLC

Practice address

6438 Joliet Rd Ste 203
Countryside, IL 60525-4624

Phone

(708) 352-5222

NPI assigned

Sep 26, 2018

Organization subpart

No

Authorized official

Name

Mr. Manish Tanna

Title

President

Phone

(630) 573-5000

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rudolph Albores, MD Internal Medicine Physician · Westmont, IL · NPI 1285692889
  Medicare reassignment Care Compare group NPD IL · INTERNAL MEDICINE
• Christopher Brenner, MD Family Medicine Physician · Countryside, IL · NPI 1629020102
  Medicare reassignment Care Compare group NPD FAMILY MEDICINE · IL
• Jacqueline J Celmer, FNP Family Nurse Practitioner · Countryside, IL · NPI 1811245178
  Medicare reassignment Care Compare group NPD IL
• David Sachtleben, MD Internal Medicine Physician · Westmont, IL · NPI 1861450447
  Medicare reassignment Care Compare group NPD IL · INTERNAL MEDICINE
• Gerald Simon, MD Internal Medicine Physician · Countryside, IL · NPI 1861450330
  Medicare reassignment Care Compare group NPD IL · INTERNAL MEDICINE

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IL

Medicare enrollment records

National Provider Directory

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18778/brand/1/csg/1/fhir/r4

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 21, 2024.

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1740765700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231557",
            "telephone_number": "630-974-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6438 JOLIET RD STE 203",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605254624",
            "telephone_number": "708-352-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 N Cass Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Westmont",
            "state": "IL",
            "postal_code": "605591745",
            "country_code": "US",
            "telephone_number": "630-963-0309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "412 63rd St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605162000",
            "country_code": "US",
            "telephone_number": "331-775-2783",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 W 22nd St",
            "address_purpose": "LOCATION",
            "city": "Oak Brook",
            "state": "IL",
            "postal_code": "605231557",
            "country_code": "US",
            "telephone_number": "630-974-5216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NANI INTERNAL MED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-26",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "TANNA",
        "authorized_official_first_name": "MANISH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-573-5000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Countryside, IL · Internal Medicine Physician in Illinois