Individual provider Active NPI

Aftab Poshni, MD

  • Psychiatry Physician
  • Crystal Lake, IL
National Provider Identifier
1821097924
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036-089593 Issued in IL
Practice address
500 Coventry LN
Suite 205
Crystal Lake, IL 60014-7579
Phone
(815) 455-7100
Fax
(815) 455-3951
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036-089593 IL Primary

Addresses

Primary practice location

500 Coventry LN
Suite 205
Crystal Lake, IL 60014-7579

Mailing address

500 Coventry LN
Suite 205
Crystal Lake, IL 60014-7579
Phone (815) 455-7100

Other identifiers 2

IdentifierTypeStateIssuer
036089593MedicaidIL
260022457OtherMEDICARE RR PTAN

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
I20101026000731 IL Practitioner - Psychiatry 1850584590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Horizons Behavioral Health LLCGroup PAC ID 4385531672, 11 clinicians

Practice addresses (Care Compare)

500 Coventry LN
Suite 205
Crystal Lake, IL 60014-7555
Phone (815) 455-7100

Hospital & facility affiliations

  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-089593ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Horizons Behavioral Health LLC CurrentSince Oct 1, 1994 Accepting new patients

Locations

500 Coventry Ln
Ste 205
Crystal Lake, IL 60014
Phone (815) 455-7100

Organizations & group practices 1

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 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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1821097924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 COVENTRY LN",
            "address_2": "SUITE 205",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147579",
            "telephone_number": "815-455-7100",
            "fax_number": "815-455-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COVENTRY LN",
            "address_2": "SUITE 205",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147579",
            "telephone_number": "815-455-7100",
            "fax_number": "815-455-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POSHNI",
        "first_name": "AFTAB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-089593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089593",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PTAN",
            "identifier": "260022457",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.