NPIMap

Individual provider Active NPI

Ravi Badlani, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1790758944
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036095133 Issued in IL
Practice address
2266 N Lincoln Ave
Lower Level
Chicago, IL 60614-3718
Phone
(773) 883-3953
NPI assigned
Feb 8, 2006
Last updated
Jun 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036095133 IL Primary

Addresses

Primary practice location

2266 N Lincoln Ave
Lower Level
Chicago, IL 60614-3718

Mailing address

952 E 54TH PL
Chicago, IL 60615-5061
Phone (773) 368-0477

Other identifiers 1

IdentifierTypeStateIssuer
036095133MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040729000058 IL Practitioner - Internal Medicine 0648240614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Virginia Commonwealth University, School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2266 N Lincoln Ave
Chicago, IL 60614-7600
Phone (773) 883-3953

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ravi Badlani MDSC Internal Medicine CurrentSince Dec 16, 2003 Accepting new patients
Vandana Badlani MD S.C. Past Accepting new patients

Locations

2266 N Lincoln Ave
Chicago, IL 60614
Phone (773) 248-3525

2266 N Lincoln Ave
Lowr
Chicago, IL 60614
Phone (773) 883-3953

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hope Hospice, IncRolling Meadows, IL, CCN 141627 Hospice Contracted Managing Employee Oct 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1790758944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "952 E 54TH PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606155061",
            "telephone_number": "773-368-0477",
            "fax_number": "312-267-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 N LINCOLN AVE",
            "address_2": "LOWER LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143718",
            "telephone_number": "773-883-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADLANI",
        "first_name": "RAVI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036095133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095133",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.