Individual Vs. Group NPI in Illinois

Federal and Illinois laws require a national provider number, or NPI, to be provided on all health insurance claim forms. Both individual physicians and group practices must obtain their own unique NPI number. Without non-pharmaceutical interventions, claims will be automatically denied.

Individual

In Illinois, individual non-pharmaceutical interventions refer to providers who are in health care businesses for themselves. This includes private practice physicians, chiropractors, and family health physicians. For health insurance claims, the individual NPI number is always listed as the billing NPI number.

Group

Grupo ISFL linking providers that are part of a larger healthcare organization. Providers using group ISFLs include multi-specialty practices and practices with more than one representative physician on staff. A group NPI number should always be placed on the claim form indicated in the payment by provider or payee field.

The registry of non-pharmaceutical interventions

If a provider has not registered an NPI with the Illinois Department of Health and Human Services and the Illinois Department of Human Services and is required to do so, then the provider should register a number as soon as possible. Registration can be done via the Internet. You can also call 217-782-0538 and request an NPI information pack.

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