Neil Puller, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Practice address

1324 N Sheridan
Victory Memorial Hospital
Waukegan, IL 60046

Phone

(847) 360-4189

Fax

(847) 360-4013

NPI assigned

Sep 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4

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.

• Waukegan Clinic Corp

  • Family Medicine Physician
  • Waukegan, IL
  • NPI 1306937289
  Medicare reassignment NPD
• Oncology Hematology Associates of Northern Illinois, LTD

  • Hematology & Oncology Physician
  • Gurnee, IL
  • NPI 1093142135
  NPD

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1932204302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN",
            "address_2": "VICTORY MEMORIAL HOSPITAL",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "847-360-4189",
            "fax_number": "847-360-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN",
            "address_2": "VICTORY MEMORIAL HOSPITAL",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "847-360-4189",
            "fax_number": "847-360-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLER",
        "first_name": "NEIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen S Powell, RN
• Wendy Powell, LCSW
• Stephanie Primmer
• Princesses and Ladies Inc.
• Pro Care Healing Inc
• Nancy S Purpura, BSN,MSN
• Britney Qualls
• Ashley Quetel
• Andrew Joseph Quinlan, PHARMD
• Ashley Lynn Quinnett, LPC, CADC

• Diagnostic Radiology Physician in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.