Individual provider Active NPI

Thomas F Kannin, MD

  • Internal Medicine Physician
  • Niles, IL
National Provider Identifier
1235132952
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036086448 Issued in IL
Practice address
6954 W Touhy Ave Ste 101
Niles, IL 60714-4535
Phone
(847) 647-1771
Fax
(847) 647-5981
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036086448 IL Primary

Addresses

Primary practice location

6954 W Touhy Ave Ste 101
Niles, IL 60714-4535

Mailing address

6954 W Touhy Ave Ste 101
Niles, IL 60714-4535
Phone (847) 647-1771

Other identifiers 1

IdentifierTypeStateIssuer
036086448MedicaidIL

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
I20090916000472 IL Practitioner - Internal Medicine 9133275142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Saint Louis University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6954 W Touhy Ave
Suite 101
Niles, IL 60714-4535
Phone (847) 647-1771

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kannin Medical Group S.C. Internal Medicine CurrentSince Sep 16, 2009 Accepting new patients

Locations

6954 W Touhy Ave
Ste 101
Niles, IL 60714
Phone (847) 647-1771

Organizations & group practices 1

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1235132952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6954 W TOUHY AVE STE 101",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144535",
            "telephone_number": "847-647-1771",
            "fax_number": "847-647-5981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6954 W TOUHY AVE STE 101",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144535",
            "telephone_number": "847-647-1771",
            "fax_number": "847-647-5981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNIN",
        "first_name": "THOMAS",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036086448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086448",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

Verify at the official NPI Registry.