Individual provider Active NPI

Bernadette Aulivola, MD

  • Vascular Surgery Physician
  • Maywood, IL
National Provider Identifier
1780658872
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
36102398 Issued in IL
Practice address
2160 S 1St Ave
EMS BLDG. Room 3216
Maywood, IL 60153-3328
Phone
(708) 216-6124
Fax
(708) 216-8658
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 36102398 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
EMS BLDG. Room 3216
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
EMS BLDG. Room 3216
Maywood, IL 60153-3328
Phone (708) 327-2700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address baulivola15536@direct.luhs.org Other

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
I20041110000094 IL Practitioner - Vascular SurgeryPractitioner - General Surgery 3375506488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Washington University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Varicose vein removal40
Leg revascularization (restoring blood flow)19
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36102398ILMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Loyola University Medical Center CurrentSince Nov 26, 2019 Accepting new patients
Loyola University Medical Center CurrentSince Nov 26, 2019 Accepting new patients

Locations

6800 N Frontage Rd
Burr Ridge, IL 60527
Phone (708) 327-1000

420 W Butterfield Rd
Elmhurst, IL 60126
Phone (630) 832-2300

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Rm 3216
Maywood, IL 60153
Phone (708) 216-6124

2160 S 1st Ave
Rm 1036
Maywood, IL 60153
Phone (708) 216-6124

2160 S 1st Ave
Bldg 109
Maywood, IL 60153

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

Organizations & group practices 3

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 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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1780658872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "EMS BLDG. ROOM 3216",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-327-2700",
            "fax_number": "708-327-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "EMS BLDG. ROOM 3216",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-6124",
            "fax_number": "708-216-8658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AULIVOLA",
        "first_name": "BERNADETTE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "36102398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "baulivola15536@direct.luhs.org",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2160 S 1st Ave",
            "address_2": "EMS BLDG. ROOM 3216",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.