Divakar Mithal, M.D., PH.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

036.147516 Issued in IL

Practice address

225 E Chicago Ave Dept of
Chicago, IL 60611-2991

Phone

(312) 227-3550

Fax

(312) 227-9450

NPI assigned

Mar 21, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Lurie Children'S Medical Group Inc

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1518064716
  Medicare reassignment NPD
• Lurie Children'S Medical Group, LLC

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1992758544
  NPD (past)
• McGaw Medical Center of Northwestern University

  • Student Health Clinic/Center
  • Chicago, IL
  • NPI 1043630098
  NPD (past)

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

{
    "created_epoch": "1395360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1992122410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-3550",
            "fax_number": "312-227-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE DEPT OF",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-3550",
            "fax_number": "312-227-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITHAL",
        "first_name": "DIVAKAR",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-21",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "IL",
            "license": "036.147516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winston A Mitchell, MD
• Yvette Mitchell, LCSW
• Serena Mitchual, D.D.S.
• Dominika Dagmara Mitera
• Salma Mitha, D.C
• Leena Bhattacharya Mithal, MD, MSCI
• Dorothy Mitkowski
• Akash Mitra, MD
• Debi Mitra, MD
• Kishen Mitra

• Neurology with Special Qualifications in Child Neurology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.