Rafiq M Kutty, MD
Individual provider Active NPI Pulmonary Disease Physician · Forest Park, IL
NPI 1114112612 · NPPES record last updated Jan 27, 2012
Key facts
- NPI
- 1114112612
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- License
- 036-111644 (IL)
- Practice address
- 7607 W Madison Ave
Forest Park, IL 60130-3513 - Phone
- (708) 366-7177
- Fax
- (708) 366-3301
- NPI assigned
- Sep 9, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Pulmonary Disease
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pulmonary Medicine Associates SC
Practice addresses (Care Compare)
801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (708) 450-4557
Hospital & facility affiliations
- Advocate Condell Medical Center
- Saint Francis Hospital-Evanston
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.4 of 100
- Quality
- 86.81
- Improvement activities
- 40
- Cost
- 77.34
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 |
|---|---|---|---|---|
| I20080918000176 | IL | Practitioner - Pulmonary Disease |
4880663467 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-111644 | IL | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loyola University Medical Center | Current | Accepting new patients | |
| Pulmonary Medicine Associates SC | Critical Care Medicine | Current |
Accepting new patients |
| Cogent Healthcare of Wisconsin, SC | Past | Accepting new patients |
Locations
800 Austin St
Ste 563
Evanston, IL 60202
Phone (847) 869-0522
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
801 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-2900
890 Garfield Ave
Ste 106
Libertyville, IL 60048
Phone (847) 325-1853
444 N Northwest Hwy
Ste 206
Park Ridge, IL 60068
Phone (847) 653-6184
Interoperability endpoints
- rafiq.kutty.1@3547.direct.athenahealth.com
- rkutty37174@direct.luhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 036111644 | IL | |
| Pulmonary Disease Physician | 207RP1001X | 036-111644 | IL | Yes |
Addresses
Primary practice location
7607 W Madison Ave
Forest Park, IL 60130-3513
Mailing address
675 W North Ave
Melrose Park, IL 60160-1634
Phone (708) 366-7177
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202964 | Other | IL | MEDICARE |
| 036111644 | Medicaid | IL | |
| 31601838 | Other | IL | BLUE CROSS BLUE SHIELD |
| 202963 | Other | IL | MEDICARE |
Other providers in Forest Park, IL
- Melanie Ketchmark
- Meeae King
- David Gerard Kleinmeyer
- Gabriela Koch Da Costa Aguiar Alves
- Narmda Kumar
- L Arche Chicago
- William Lach
- Emeryle D Ladd
- Julie Lambe
- Zachary Langgle
All providers in Forest Park, IL · Pulmonary Disease 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 Jan 27, 2012. 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.