Anjuli S. Nayak, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

ANJULI S. NAYAK, M.D.

Practice address

2010 Jacobssen Dr
Normal, IL 61761-6280

Phone

(309) 452-0995

Fax

(309) 862-0961

NPI assigned

Jul 19, 2011

Last updated

Jul 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Rande Michelle Anderson

Title

Credentialing/Billing

Phone

(309) 452-0995

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311033600000",
    "number": "1922396399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 JACOBSSEN DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616280",
            "telephone_number": "309-452-0995",
            "fax_number": "309-862-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 JACOBSSEN DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616280",
            "telephone_number": "309-452-0995",
            "fax_number": "309-862-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANJULI S. NAYAK, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RANDE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING/BILLING",
        "authorized_official_telephone_number": "309-452-0995",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Normal, IL
• Providers in Normal, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.