NPIMap

Individual provider Active NPI

Eric R Kallwitz, M.D.

  • Gastroenterology Physician
  • Chicago, IL
National Provider Identifier
1275716607
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036113292 Issued in IL
Practice address
840 S Wood St FL 7
MC 716
Chicago, IL 60612-4325
Phone
(312) 996-6651
NPI assigned
Dec 7, 2007
Last updated
Jan 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036113292 IL
Gastroenterology Physician 207RG0100X 036113292 IL Primary

Addresses

Primary practice location

840 S Wood St FL 7
MC 716
Chicago, IL 60612-4325

Mailing address

840 S Wood St FL 7
MC 716
Chicago, IL 60612-4325
Phone (312) 996-6651

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ekallwitz47561@direct.luhs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080925000180 IL Practitioner - GastroenterologyPractitioner - Internal MedicinePractitioner - Other (Physician) 7416024997 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Rush Medical College of Rush University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Jul 1, 2012 Accepting new patients
Illinois Gastroenterology Group, LLC Gastroenterology CurrentSince Feb 1, 2014 Accepting new patients
Loyola University Medical Center CurrentSince Jul 1, 2012 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Northwest Gastroenterologists SC Current Accepting new patients
Elgin Gastroenterology SC Gastroenterology Current Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients
The Board of Trustees of the University of Illinois PastSince Apr 6, 2023 Accepting new patients

Locations

2800 N Sheridan Rd
Ste 606
Chicago, IL 60657
Phone (773) 525-8846

745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

Organizations & group practices 8

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

Hospital & facility affiliations 7

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": "1196985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1275716607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST FL 7",
            "address_2": "MC 716",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST FL 7",
            "address_2": "MC 716",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLWITZ",
        "first_name": "ERIC",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-07",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036113292",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036113292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ekallwitz47561@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "840 S Wood St Fl 7",
            "address_2": "MC 716",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606124325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.