Individual provider Active NPI

William R Kehoe, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1285669457
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Practice address
1725 W Harrison
Suite 318
Chicago, IL 60612
Phone
(312) 942-6647
Fax
(312) 942-3730
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

1725 W Harrison
Suite 318
Chicago, IL 60612

Mailing address

1725 W Harrison
Suite 318
Chicago, IL 60612
Phone (312) 942-6647

Other identifiers 1

IdentifierTypeStateIssuer
21609140OtherBCBS

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
I20081205000606 IL Practitioner - Internal Medicine 1456246404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kehoe and Djordjevic S.C.Group PAC ID 7719048982, 2 clinicians

Practice addresses (Care Compare)

1725 W Harrison St
Suite 106
Chicago, IL 60612-3863
Phone (312) 942-3798

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119
  • Copley Memorial Hospital Hospital, Aurora, IL, CCN 140029
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Shirley Ryan Abilitylab Inpatient rehabilitation facility, Chicago, IL, CCN 143026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036053934ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kehoe & Djordjevic S.C. Internal Medicine CurrentSince Aug 1, 2008 Accepting new patients

Locations

1725 W Harrison St
Ste 106
Chicago, IL 60612
Phone (312) 666-2225

9669 Kenton Ave
Ste 308
Skokie, IL 60076
Phone (847) 236-1300

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285669457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON",
            "address_2": "SUITE 318",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-942-6647",
            "fax_number": "312-942-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON",
            "address_2": "SUITE 318",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-942-6647",
            "fax_number": "312-942-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEHOE",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "21609140",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.