Individual provider Active NPI

Kaveh Rahmani, DO

  • Family Medicine Physician
  • Crestwood, IL
National Provider Identifier
1215224779
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-133777 Issued in IL
Practice address
4742 Cal Sag Rd
Crestwood, IL 60445-1423
Phone
(708) 342-3000
Fax
(708) 342-3060
NPI assigned
Jul 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-133777 IL Primary

Addresses

Primary practice location

4742 Cal Sag Rd
Crestwood, IL 60445-1423

Mailing address

27702 Network PL
Chicago, IL 60673-1277
Phone (708) 862-7674

Other identifiers 2

IdentifierTypeStateIssuer
036133777MedicaidIL
P01365070OtherILRRM

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140806001868 IL Practitioner - Family Practice 1254558745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ucm Medical Group Sub LLCGroup PAC ID 4688635337, 101 clinicians

Practice addresses (Care Compare)

1 Ingalls Dr
Harvey, IL 60426-3558
Phone (708) 333-2300

17805 Halsted St
Homewood, IL 60430-2011
Phone (708) 333-2300

19550 Governors Hwy
Suite 2000
Flossmoor, IL 60422-2142
Phone (708) 957-8750

Hospital & facility affiliations

  • Ingalls Home Care Inc. Home health agency, Harvey, IL, CCN 147435
  • Franciscan Home Care Home health agency, Olympia Fields, IL, CCN 147267
  • Advocate Home Health Care Serv Home health agency, Oakbrook, IL, CCN 147150
  • Ingalls Memorial Hospital Hospital, Harvey, IL, CCN 140191
  • The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088
  • Franciscan Health Olympia & Chicago Heights Hospital, Olympia Fields, IL, CCN 140172

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-133777ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Chicago CurrentSince Jan 10, 2023 Accepting new patients
University of Chicago CurrentSince Jan 10, 2023 Accepting new patients
Ucm Medical Group Sub, LLC Family Medicine CurrentSince Aug 1, 2014 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

47 W Polk St
Ste G1
Chicago, IL 60605
Phone (312) 567-6700

27702 Network Pl
Chicago, IL 60673

4742 Cal Sag Rd
Crestwood, IL 60418
Phone (708) 915-2727

19550 Governors Hwy
Ste 2000
Flossmoor, IL 60422
Phone (708) 272-6606

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

6701 159th St
#1
Tinley Park, IL 60477
Phone (708) 444-2226

Interoperability endpoints

  • Direct secure messaging: krahmani179487@uchospital.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ingalls Memorial HospitalHarvey, IL, CCN 14T191 Hospital Corporate Director Jan 17, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1215224779",
    "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": "4742 CAL SAG RD",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604451423",
            "telephone_number": "708-342-3000",
            "fax_number": "708-342-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMANI",
        "first_name": "KAVEH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-133777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036133777",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "P01365070",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestwood, IL

Sources for this page

Verify at the official NPI Registry.