Individual provider Active NPI

Anupama Lakshmi Ananth, D.O.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1962636381
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.129255 Issued in IL
Practice address
2555 S. Martin Luther King, Jr. Drive
Chicago, IL 60616-5500
Phone
(312) 609-0300
Fax
(312) 842-5897
NPI assigned
May 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.129255 IL Primary

Addresses

Primary practice location

2555 S. Martin Luther King, Jr. Drive
Chicago, IL 60616-5500

Mailing address

4901 W 79TH St
Burbank, IL 60459-1554
Phone (312) 609-0300

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
I20121105000386 IL Practitioner - Internal Medicine 9638320401 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.129255ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Internal Medicine CurrentSince Aug 15, 2012 Accepting new patients
Rush University Medical Center Internal Medicine CurrentSince Aug 15, 2012 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

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

Organizations & group practices 2

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": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1962636381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 W 79TH ST",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591554",
            "telephone_number": "312-609-0300",
            "fax_number": "312-842-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 S. MARTIN LUTHER KING, JR. DRIVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606165500",
            "telephone_number": "312-609-0300",
            "fax_number": "312-842-5897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANANTH",
        "first_name": "ANUPAMA",
        "middle_name": "LAKSHMI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.129255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.