Individual provider Active NPI

Adriana Marie Spellman, M.D.

  • Obstetrics & Gynecology Physician
  • Libertyville, IL
National Provider Identifier
1760474589
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036-078559 Issued in IL
Practice address
801 S Milwaukee Ave
Ste 100
Libertyville, IL 60048-3204
Phone
(847) 680-3400
NPI assigned
Aug 17, 2005
Last updated
Dec 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036-078559 IL Primary

Addresses

Primary practice location

801 S Milwaukee Ave
Ste 100
Libertyville, IL 60048-3204

Mailing address

801 S Milwaukee Ave
Ste 100
Libertyville, IL 60048-3204
Phone (847) 680-3400

Other identifiers 1

IdentifierTypeStateIssuer
1760474589MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address aspellman234524@direct.myadvocateaurora.org Direct
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
I20100726000844 IL Practitioner - Obstetrics/Gynecology 4789766940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loyola University of Chicago, Stritch School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OB-Gyne Associates of Libertyville SCGroup PAC ID 7618059874, 7 clinicians

Practice addresses (Care Compare)

801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 680-3400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-078559ILMDObstetrics & Gynecology Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1760474589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S MILWAUKEE AVE",
            "address_2": "STE 100",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483204",
            "telephone_number": "847-680-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S MILWAUKEE AVE",
            "address_2": "STE 100",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483204",
            "telephone_number": "847-680-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLMAN",
        "first_name": "ADRIANA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-078559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760474589",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aspellman234524@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "801 S Milwaukee Ave",
            "address_2": "STE 100",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600483204",
            "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": "801 S Milwaukee Ave",
            "address_2": "STE 100",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600483204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.