Mary Kanashiro, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036088831 Issued in IL

Practice address

6703 W 159TH Street
Suite 109
Tinley Park, IL 60477-1782

Phone

(708) 532-1104

Fax

(708) 532-5539

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

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

Practice roles

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

• Cardiology-Internal Medicine Consultants SC

  • Cardiovascular Disease Physician
  • Harvey, IL
  • NPI 1932370616

  Internal Medicine

  NPD (past)
• Cardiology-Internal Medicine Consultants, S.C.

  • Internal Medicine Physician
  • Tinley Park, IL
  • NPI 1568484665
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1114949211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27702 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731277",
            "telephone_number": "708-862-7674",
            "fax_number": "708-862-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6703 W 159TH STREET",
            "address_2": "SUITE 109",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771782",
            "telephone_number": "708-532-1104",
            "fax_number": "708-532-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANASHIRO",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036088831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088831",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "231199013",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "P00940434",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Allen Kaapke, DC
• Kais Place Behavioral and Family Services LLC
• Vivek Kaistha, M.D.
• John P. Kalamaris, D.O.
• Angela Marie Kamely, RRT
• Walid K Kandah, DO
• Kankakee Internal Medicine Group
• Sandra A Kapadia, PHARMD
• Emily Karamagianis, D.D.S.
• Lauren Karr

• Internal Medicine Physician in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.