Individual provider Active NPI

Revathi Suppiah, M.D.

  • Medical Oncology Physician
  • Aurora, IL
National Provider Identifier
1760644116
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
036.117787 Issued in IL
Practice address
1221 N Highland Ave
Aurora, IL 60506-1404
Phone
(630) 859-8700
NPI assigned
Jun 26, 2008
Last updated
Mar 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 036.117787 IL Primary

Addresses

Primary practice location

1221 N Highland Ave
Aurora, IL 60506-1404

Mailing address

28594 Network PL
Chicago, IL 60673-1285
Phone (630) 859-6800

Other practice location 1

2520 Elisha Avenue
Zion, IL 60099
Phone (800) 322-9183

Other identifiers 1

IdentifierTypeStateIssuer
036117787MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address rsuppiah329968@direct.myadvocateaurora.org Direct

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
I20090304000152 IL Practitioner - Medical Oncology 4880750637 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1800 Hollister Dr
Suite 112
Libertyville, IL 60048-5265
Phone (847) 367-6781

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.117787ILMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jul 17, 2023 Accepting new patients
City of Hope Medical Group of Illinois PLLC CurrentSince Nov 28, 2012 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 17, 2023 Accepting new patients
Advocate North Side Health Network Past Accepting new patients
City of Hope Medical Group of Arizona LLC Medical Oncology PastSince Oct 17, 2021 Accepting new patients

Locations

1221 N Highland Ave
Aurora, IL 60506
Phone (630) 859-6700

2357 Sequoia Dr
Aurora, IL 60506
Phone (630) 859-6700

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

2361 Paysphere Cir
Chicago, IL 60674
Phone (847) 746-4358

29373 Network Pl
Chicago, IL 60673

1800 Hollister Dr
Ste 112
Libertyville, IL 60048
Phone (708) 367-6781

801 S Milwaukee Ave
Ste 1140
Libertyville, IL 60048
Phone (847) 990-2496

2520 Elisha Ave
Zion, IL 60099
Phone (800) 322-9183

Interoperability endpoints

  • Direct secure messaging: revathi.suppiah.p1@direct.ctca-clinic.nextgenshare.com
  • Direct secure messaging: rsuppiah329968@direct.myadvocateaurora.org

Organizations & group practices 5

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 6

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1760644116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28594 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731285",
            "telephone_number": "630-859-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061404",
            "telephone_number": "630-859-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2520 Elisha Avenue",
            "address_purpose": "LOCATION",
            "city": "Zion",
            "state": "IL",
            "postal_code": "60099",
            "country_code": "US",
            "telephone_number": "800-322-9183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUPPIAH",
        "first_name": "REVATHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IL",
            "license": "036.117787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117787",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1221 N Highland Ave",
            "city": "Aurora",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605061404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsuppiah329968@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1221 N Highland Ave",
            "city": "Aurora",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605061404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.