Individual provider Active NPI

Radhika Chimata, M.D.

  • Psychiatry Physician
  • Des Plaines, IL
National Provider Identifier
1881078392
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036150151 Issued in IL
Practice address
555 Wilson LN
Des Plaines, IL 60016-4729
Phone
(847) 768-5330
Fax
(847) 768-5341
NPI assigned
Jul 14, 2015
Last updated
Sep 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 036.150511 IL
Psychiatry Physician 2084P0800X 036150151 IL Primary

Addresses

Primary practice location

555 Wilson LN
Des Plaines, IL 60016-4729

Mailing address

1533 Balsam LN
Woodridge, IL 60517-4643
Phone (847) 768-5330

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
I20191105000703 IL Practitioner - Psychiatry 3678864626 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
2014 Health LLCGroup PAC ID 2365764024, 22 clinicians

Practice addresses (Care Compare)

555 Wilson LN
Des Plaines, IL 60016-4729
Phone (212) 243-5565

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.150511ILMDAddiction Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
2014 Health, LLC CurrentSince Dec 27, 2021 Accepting new patients
Gateway Professional Services, PC CurrentSince Aug 9, 2024 Accepting new patients
Gateway Professional Services, PC CurrentSince Aug 9, 2024 Accepting new patients
BHC Streamwood Hospital Inc. CurrentSince Jun 20, 2020 Accepting new patients
Gateway Professional Services, PC Current Accepting new patients

Locations

400 Mercy Ln
Aurora, IL 60506
Phone (630) 966-7400

1080 E Park St
Carbondale, IL 62901
Phone (618) 529-1151

55 E Jackson Blvd
Ste 1500
Chicago, IL 60604

555 Wilson Ln
Des Plaines, IL 60016
Phone (212) 243-5565

1400 E Irving Park Rd
Streamwood, IL 60107
Phone (630) 483-5578

Interoperability endpoints

  • Direct secure messaging: rchimata58309@direct.et0946.epichosted.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1881078392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 BALSAM LN",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605174643",
            "telephone_number": "847-768-5330",
            "fax_number": "847-768-5341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 WILSON LN",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164729",
            "telephone_number": "847-768-5330",
            "fax_number": "847-768-5341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIMATA",
        "first_name": "RADHIKA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-14",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "IL",
            "license": "036.150511",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036150151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

Verify at the official NPI Registry.