Physician Compare National (NPI:1649384256)

HEALTHCARE PROVIDER: AZITA ARDAKANI M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1649384256
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4385648997
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111212000614
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ARDAKANI
	Individual professional last name
Provider First Name	AZITA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1987
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ADVENTIST HEALTH PARTNERS INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0244135762
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	169
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5201 WILLOW SPRINGS RD
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	LA GRANGE
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	605256540
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7082456097
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140008
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GOTTLIEB MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y