Blue Cross Blue Shield of Illinois - NPI: How to Share your NPI Number

Claims Filing Tips

NPI: How to Share your NPI Number

Share your NPI with BCBSIL today! We've made it even easier for you to share your NPI with BCBSIL! Simply fill in all of the fields below and click on “Submit” to forward your information to us. We will attempt to verify your NPI using the NPPES registry. If your NPI is not found on the NPI Registry, or if any data doesn't match, then we reserve the right to request submission of your confirmation notice (letter or e-mail) from the Enumerator. All fields are required. (If not applicable, write "N/A")
Legal Name of Provider:
Suffix/Title/Credential:
Type 1 Individual NPI:
Legal Business Name of Group:
Type 2 Organizational NPI:
Existing BCBSIL Provider Number(s), if applicable:
Taxonomy Code(s):
Primary Specialty:
IRS Tax ID Number (SSN, ITIN, or EIN):
State License Number:
Primary Office Address:
City/State/Zip:
Contact's Name:
Contact's telephone number:
Contact's e-mail address:

Attestation: I hereby certify that the NPI information submitted within this form is accurate and complete in accordance with the confirmation letter or email sent to me by the NPPES Enumerator. I understand and agree that any misrepresentation in this form by omission or affirmative statement may result in reimbursement delays and/or other disruptions in service. Yes No