Illinois Digestive and Liver Disease Specialists LTD
Organization Active NPI Gastroenterology Physician · Chicago, IL
NPI 1891336053 · NPPES record last updated Nov 6, 2019
Key facts
- NPI
- 1891336053
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- Legal business name
- ILLINOIS DIGESTIVE AND LIVER DISEASE SPECIALISTS LTD
- Practice address
- 2222 W Division St Ste 220
Chicago, IL 60622-3094 - Phone
- (773) 883-0800
- NPI assigned
- Sep 30, 2019
- Organization subpart
- No
Authorized official
- Name
- Amritbhai Patel, MD
- Title
- Ceo
- Phone
- (773) 883-0800
Practitioners 2
-
Anna Amritbhai Patel, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191112001334 | IL | Part B Supplier - Clinic/Group Practice | 2264864305 |
Receives reassigned benefits from 2 practitioners Practice locations: Chicago, IL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician |
207RG0100X | Yes |
Addresses
Primary practice location
2222 W Division St Ste 220
Chicago, IL 60622-3094
Mailing address
2222 W Division St Ste 220
Chicago, IL 60622-3094
Phone (773) 883-0800
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All providers in Chicago, IL · Gastroenterology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.