Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nithin Charlly, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1831849744

Nithin Charlly, MD is a Family Practice in Grayslake, Illinois. Qualified in 2022, 4 years ago. Practices with Innovative Platinum Care, SC, a 19-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
4
Licensed in
IL
In the registry since
2022
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1475 E Belvidere Rd Ste 385
Grayslake, IL 60030-2012
Phone: (847) 535-7157
Fax: (312) 694-0655
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2418 N Ashland Ave, Chicago, IL 60614-2021 — (773) 900-8330

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 125079374 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1831849744
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 24, 2022
Last updated in NPPESSeptember 2, 2025
Certification dateSeptember 2, 2025
Mailing address1475 E Belvidere Rd Unit 385, Grayslake, IL 60030-2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Innovative Platinum Care, Sc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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