Tamayo Kawai, M.D.
Individual provider Active NPI Addiction Medicine (Family Medicine) Physician · Melrose Park, IL
NPI 1093977530 · NPPES record last updated Feb 17, 2021
Key facts
- NPI
- 1093977530
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction Medicine (Family Medicine) Physician 207QA0401X
- License
- 036127334 (IL)
- Practice address
- 1111 Superior St Ste 101
Melrose Park, IL 60160-4100 - Phone
- (708) 406-3040
- NPI assigned
- Jun 26, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 18
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- PCC Community Wellness Center
Practice addresses (Care Compare)
1111 Superior St
Suite 101
Melrose Park, IL 60160-4100
Phone (708) 406-3040
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110919000759 | IL | Practitioner - Hospitalist |
1254502412 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PCC Community Wellness Center | Current |
Accepting new patients | |
| Freeport Memorial Hospital | Current |
Accepting new patients | |
| PCC Community Wellness Center | Current |
Accepting new patients | |
| PCC Community Wellness Center | Past | Accepting new patients |
Locations
421 W Exchange St
Freeport, IL 61032
Phone (815) 599-7300
1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105
1111 Superior St
Ste 101
Melrose Park, IL 60160
Phone (708) 344-2161
14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113
Interoperability endpoints
- tamayo.kawai.1@13158.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036127334 | IL | |
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 036127334 | IL | Yes |
Addresses
Primary practice location
1111 Superior St Ste 101
Melrose Park, IL 60160-4100
Mailing address
1111 Superior St Ste 101
Melrose Park, IL 60160-4100
Phone (708) 406-3040
Other providers in Melrose Park, IL
- Steven Kasperski
- Michelle A. Kassen
- Jaya Kasturi
- Kasturi, P.C.
- Anastasia Katopodis
- Jacara Kelley-Muhammad
- Karl Kettelhut
- Khalil Y Karim, MD, SC
- Asmat Khan
- Khurana Family Eyecare, PLLC
All providers in Melrose Park, IL · Addiction Medicine (Family Medicine) Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.