NPIMap

Individual provider Active NPI

Kirill Zhadovich, M.D.

  • Internal Medicine Physician
  • Niles, IL
National Provider Identifier
1003881699
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036106200 Issued in IL
Practice address
7900 N Milwaukee Ave
Suite 2-24
Niles, IL 60714-3159
Phone
(847) 825-0800
Fax
(847) 825-0803
NPI assigned
Feb 17, 2006
Last updated
Jan 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036-106200 IL
Internal Medicine Physician 207R00000X 036106200 IL Primary

Addresses

Primary practice location

7900 N Milwaukee Ave
Suite 2-24
Niles, IL 60714-3159

Mailing address

PO Box 2056
Northbrook, IL 60065-2056
Phone (847) 858-7367

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050907000185 IL Practitioner - Internal Medicine 6608808423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kirill Zhadovich, M.D., S.C.Group PAC ID 3072545896, 4 clinicians

Practice addresses (Care Compare)

7900 N Milwaukee Ave
Suite 2 24
Niles, IL 60714-3186
Phone (847) 825-0800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036106200ILMDInternal Medicine Physician
036-106200ILMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kirill Zhadovich, M.D., S.C. CurrentSince Jan 6, 2003 Accepting new patients
Advanced Primary Care, SC Past Accepting new patients

Locations

9410 Waukegan Rd
Morton Grove, IL 60053
Phone (847) 626-1600

7900 N Milwaukee Ave
Ste 2-24
Niles, IL 60714
Phone (847) 626-1600

565 Lakeview Pkwy
Ste 190
Vernon Hills, IL 60061
Phone (847) 984-6490

Networks

  • IL PPO Downstate
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IL HMO C-SNP
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBGFBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CBGFBA/Endpoint/CBGFBA

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1003881699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2056",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600652056",
            "telephone_number": "847-858-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 N MILWAUKEE AVE",
            "address_2": "SUITE 2-24",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143159",
            "telephone_number": "847-825-0800",
            "fax_number": "847-825-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHADOVICH",
        "first_name": "KIRILL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036-106200",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036106200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

Verify at the official NPI Registry.