NPIMap

Individual provider Active NPI

Anandavally Pillai

  • Geriatric Medicine (Internal Medicine) Physician
  • Joliet, IL
National Provider Identifier
1821083791
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
036-087425 Issued in IL
Practice address
1051 Essington Rd
Suite 100
Joliet, IL 60435-2801
Phone
(815) 744-4440
Fax
(815) 744-9360
NPI assigned
Sep 15, 2005
Last updated
Sep 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X 036087425 IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036-087425 IL Primary

Addresses

Primary practice location

1051 Essington Rd
Suite 100
Joliet, IL 60435-2801

Mailing address

1051 Essington Road
Suite 100
Joliet, IL 60435-2801
Phone (815) 744-4440

Other identifiers 2

IdentifierTypeStateIssuer
036087425MedicaidIL
09932356OtherILBC/BS

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
I20050922000981 IL Practitioner - Family PracticePractitioner - Geriatric Medicine 2163452574 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Service Systems, IncGroup PAC ID 2264408699, 63 clinicians

Practice addresses (Care Compare)

1890 Silver Cross Blvd
Suite 265
New Lenox, IL 60451-9623
Phone (815) 727-4292

1900 Silver Cross Blvd
New Lenox, IL 60451-9509

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-087425ILMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Service Systems, Inc CurrentSince Jan 1, 2013 Accepting new patients
Health Service Systems, Inc CurrentSince Jan 1, 2013 Accepting new patients
PCP of Essington Past Accepting new patients
Fastrac Medical, P.C. Past Accepting new patients
Primary Care Physicans Legal Medicine Past Accepting new patients
Lake Mi Mobile Doctors P.C. Geriatric Medicine Past Accepting new patients

Locations

1051 Essington Rd
Ste 100
Joliet, IL 60435
Phone (815) 744-4440

1890 Silver Cross Blvd
Ste 265
New Lenox, IL 60451
Phone (815) 727-4292

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 7

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1821083791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 ESSINGTON ROAD",
            "address_2": "SUITE 100",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352801",
            "telephone_number": "815-744-4440",
            "fax_number": "815-744-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 ESSINGTON RD",
            "address_2": "SUITE 100",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352801",
            "telephone_number": "815-744-4440",
            "fax_number": "815-744-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILLAI",
        "first_name": "ANANDAVALLY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "IL",
            "license": "036087425",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036-087425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087425",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "09932356",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.