NPIMap

Organization Active NPI

Kidney and Hypertension Associates LTD

  • Nephrology Physician
  • Evergreen Park, IL
National Provider Identifier
1265511984
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
KIDNEY AND HYPERTENSION ASSOCIATES LTD
Practice address
3913 W 95TH St
Evergreen Park, IL 60805-1903
Phone
(708) 422-9771
NPI assigned
Nov 3, 2006
Last updated
Jan 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Authorized official

Name
Rose White
Title
Billing Manager
Phone
(815) 462-9035

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X Primary

Addresses

Primary practice location

3913 W 95TH St
Evergreen Park, IL 60805-1903

Mailing address

713 Saint Josephs Dr
Oak Brook, IL 60523-2570
Phone (708) 422-9771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050910000077 IL Part B Supplier - Clinic/Group Practice 3577595545 Receives reassigned benefits from 7 practitioners
Practice locations: Alsip, IL; Tinley Park, IL; Summit, IL; Orland Park, IL; Oak Lawn, IL; Merrionette Park, IL; Matteson, IL; Joliet, IL…

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

11500 S Pulaski Rd
Alsip, IL 60803
Phone (708) 385-7145

12250 S Cicero Ave
Alsip, IL 60803
Phone (708) 389-0955

2310 York St
Blue Island, IL 60406
Phone (708) 385-8820

8109 S Western Ave
Chicago, IL 60620
Phone (773) 778-0173

9115 S Cicero Ave
Ste 300
Oak Lawn, IL 60453
Phone (708) 907-3066

9160 W 159th St
Orland Park, IL 60462
Phone (708) 403-2790

314 Ridge Rd
Munster, IN 46321
Phone (219) 789-1169

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1265511984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 SAINT JOSEPHS DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232570",
            "telephone_number": "708-422-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3913 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051903",
            "telephone_number": "708-422-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY AND HYPERTENSION ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "815-462-9035"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.