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Deactivated NPI 1215042312 Deactivated / Inactive NPI Female Practitioner

Dr. Anjuli Seth Nayak , MD

Specialist • Normal, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Anjuli Nayak has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 20, 2006
NPI Deactivation Date January 13, 2017
Total Practice Duration ~11 Years of Practice (2006 – 2017)

Professional Overview & Biography Verified Profile Summary

Dr. Anjuli Nayak, MD was a registered Specialist practicing in Normal, IL. Throughout an active medical career spanning 11 years, Dr. Nayak provided care at the practice location at 2010 JACOBSSEN DR until profile deactivation on 2017-01-13.

Practice Location & Contact Primary Location

Practice Address

2010 Jacobssen Dr

Normal, IL 617616280

Telephone 3094520995
Fax 3098620961
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Normal, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 38.5 Yrs
Regional Practice Density
4 Specialists

Practicing in Normal, IL (1322 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License IL 036-059339

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Dr. Nicholas Nayak , MD

Clinic/Center - Primary Care

NPI 1457439317

Doctor of Medicine (M.D.)

Kathleen Lally , NP

Nurse Practitioner - Family

NPI 1508365842

Nurse Practitioner

Dr. Phoebe Panopio , MD

Internal Medicine

NPI 1710070289

Doctor of Medicine (M.D.)

Dr. Dareen Siri , MD

Internal Medicine - Allergy & Immunology

NPI 1730272998

Doctor of Medicine (M.D.)

Dana Dalbak , PA-C

Physician Assistant

NPI 1790721298

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 13, 2017

Record deactivated on January 13, 2017

NPI Profile Active October 24, 2011

NPI status registered as active in NPPES database

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Updated Practice Location October 24, 2011

Registered at 2010 JACOBSSEN DR, NORMAL, IL 617616280 (Tel: 3094520995)

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Updated Business Mailing Address October 24, 2011

Registered at 2010 JACOBSSEN DR, NORMAL, IL 617616280 (Tel: 3094520995)

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Provider Name / Credentials Updated October 24, 2011

Recorded as ANJULI NAYAK, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 24, 2011

Specialist (License #036-059339 in IL)

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Initial NPI Registration & Enumeration August 20, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1215042312
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 20, 2006
Last Update: October 24, 2011
Deactivation Date: January 13, 2017

Mailing Address

2010 Jacobssen Dr

Normal, IL 617616280

Phone: 3094520995

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.