Individual provider Active NPI

Suby Aby Panichikudiyil, NP

  • Nurse Practitioner
  • Naperville, IL
National Provider Identifier
1790158186
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-028978 Issued in IL
Practice address
2940 Rollingridge Rd Ste 201
Naperville, IL 60564-4217
Phone
(630) 967-6000
Fax
(630) 428-3971
NPI assigned
Nov 6, 2015
Last updated
Aug 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209-028978 IL Primary
Family Nurse Practitioner 363LF0000X 209028978 IL

Addresses

Primary practice location

2940 Rollingridge Rd Ste 201
Naperville, IL 60564-4217

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other practice location 1

10719 160th St
Orland Park, IL 60467-5541
Phone (630) 607-1000

Other practice location 2

5851 W 95th St
Oak Lawn, IL 60453-2394
Phone (630) 607-1000

Other practice location 3

2100 Clearwater Dr Ste 100
Oak Brook, IL 60523-1931
Phone (630) 607-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spanichikudiyil379368@dulyhealthandcare.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151229000234 WI Practitioner - Nurse Practitioner 4981905411
I20240425000918 IL Practitioner - Nurse Practitioner 4981905411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Pain Consultants, S.C.Group PAC ID 8325132988, 3 clinicians

Practice addresses (Care Compare)

2100 Clearwater Dr
Suite 100
Oak Brook, IL 60523-1931
Phone (630) 607-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain Consultants, S.C. CurrentSince Mar 1, 2024 Accepting new patients
Advanced Pain Management, SC CurrentSince Jun 24, 2016 Accepting new patients
Advanced Pain Management SC CurrentSince Jun 24, 2016 Accepting new patients
Dupage Medical Group LTD CurrentSince Aug 17, 2026 Accepting new patients
Madison Surgicenter LLC Past Accepting new patients
Dupage Medical Group LTD PastSince Aug 17, 2026 Accepting new patients
Advanced Pain Treatment of Chicago SC PastSince Oct 1, 2020 Accepting new patients

Locations

2940 Rollingridge Rd
Ste 201
Naperville, IL 60564
Phone (630) 967-6000

2940 Rollingridge Rd
Ste 300
Naperville, IL 60564
Phone (630) 646-5800

2100 Clearwater Dr
Ste 100
Oak Brook, IL 60523
Phone (630) 581-3801

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

4131 W Loomis Rd
Ste 300
Milwaukee, WI 53221
Phone (414) 325-3713

4448 W Loomis Rd
Ste 202
Milwaukee, WI 53220
Phone (414) 218-8096

333 Pine Ridge Blvd
Ste 320
Wausau, WI 54401

Organizations & group practices 7

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 1

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": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1790158186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 ROLLINGRIDGE RD STE 201",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644217",
            "telephone_number": "630-967-6000",
            "fax_number": "630-428-3971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10719 160th St",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604675541",
            "country_code": "US",
            "telephone_number": "630-607-1000",
            "fax_number": "630-607-1002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5851 W 95th St",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604532394",
            "country_code": "US",
            "telephone_number": "630-607-1000",
            "fax_number": "630-607-1002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Clearwater Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Oak Brook",
            "state": "IL",
            "postal_code": "605231931",
            "country_code": "US",
            "telephone_number": "630-607-1000",
            "fax_number": "630-607-1002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANICHIKUDIYIL",
        "first_name": "SUBY",
        "middle_name": "ABY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-06",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-028978",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209028978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spanichikudiyil379368@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2940 Rollingridge Rd Ste 201",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605644217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.