Kishore Bobba, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

36117320 Issued in IL

Practice address

3800 W Madison St
Chicago, IL 60624-2334

Phone

(773) 826-6600

Fax

(773) 826-1407

NPI assigned

May 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023223161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 W HOLLYWOOD AVE",
            "address_2": "APT 406",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606604506",
            "telephone_number": "773-290-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606242334",
            "telephone_number": "773-826-6600",
            "fax_number": "773-826-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBBA",
        "first_name": "KISHORE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36117320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Mary Boatwright, M.D.,
• Jessica Bobadilla, LCSW
• Jonathan Bobadilla
• Alyssa Bobak, PA-C
• Marina Bobanovic
• Kaitlyn Elizabeth Bobbitt, DPT
• Bobby E Wright CBHC, Inc
• Bobby E Wright Ccmhc
• Bobby E Wright Ccmhc
• Bobby E Wright Comprehensive Behavioral Health Center Inc.

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.