Individual provider Active NPI

Indraneel Gowdar, MD

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1881030260
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036150260 Issued in IL
Practice address
1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone
(312) 942-5000
NPI assigned
May 13, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 036150260 IL
Diagnostic Radiology Physician 2085R0202X 73055 WI
Diagnostic Radiology Physician 2085R0202X 125069721 IL
Diagnostic Radiology Physician 2085R0202X 036150260 IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy
Chicago, IL 60612-3833

Mailing address

1653 W Congress Pkwy
Chicago, IL 60612-3833

Other practice location 1

600 Highland Ave
Madison, WI 53792-5000
Phone (608) 263-9729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL, IN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200901001892 WI Practitioner - Diagnostic Radiology 1850679994 Reassigns benefits to 2 organizations
I20210913000212 IL Practitioner - Diagnostic Radiology 1850679994 Reassigns benefits to 1 organization
I20230221001293 IN Practitioner - Diagnostic Radiology 1850679994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 563-4270

9200 Calumet Ave
Suite E107
Munster, IN 46321-2885
Phone (219) 806-6585

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
73055WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Diagnostic Radiology CurrentSince Oct 1, 2021 Accepting new patients
Fort Healthcare Inc CurrentSince Jul 1, 2020 Accepting new patients
Richland Hospital CurrentSince Jul 1, 2020 Accepting new patients
Rush University Medical Center Diagnostic Radiology CurrentSince Oct 1, 2021 Accepting new patients
Fort Healthcare Inc CurrentSince Jul 1, 2020 Accepting new patients
Richland Hospital CurrentSince Jul 1, 2020 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

9200 Calumet Ave
Ste E107
Munster, IN 46321
Phone (219) 806-6585

9200 Calumet Ave
Ste 107
Munster, IN 46321

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

333 E 2nd St
Richland Ctr, WI 53581
Phone (608) 647-6161

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/

Organizations & group practices 6

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": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1881030260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537925000",
            "country_code": "US",
            "telephone_number": "608-263-9729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOWDAR",
        "first_name": "INDRANEEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-13",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "IL",
            "license": "036150260",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "73055",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125069721",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036150260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.