NPIMap

Individual provider Active NPI

Andrea Michelle Kane, MD

  • Pediatrics Physician
  • Bloomington, IL
National Provider Identifier
1285804724
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036.120210 Issued in IL
Practice address
3024 E Empire St
Bloomington, IL 61704-5402
Phone
(309) 556-7337
NPI assigned
Mar 11, 2008
Last updated
Feb 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036.120210 IL Primary

Addresses

Primary practice location

3024 E Empire St
Bloomington, IL 61704-5402

Mailing address

3024 E Empire St
Bloomington, IL 61704-5402
Phone (309) 556-7337

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
I20100708000745 IL Practitioner - Pediatric Medicine 5991836967 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.120210ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Medical Group CurrentSince Oct 4, 2025 Accepting new patients
Carle West Physician Group Inc CurrentSince Jul 1, 2020 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 1, 2014 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 1, 2014 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Bromenn Physicians Management Corporation Pediatrics Past Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

3024 E Empire St
Bloomington, IL 61704
Phone (309) 556-7500

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

3310 Fields South Dr
Champaign, IL 61822
Phone (217) 902-5300

29373 Network Pl
Chicago, IL 60673

911 S Chestnut St
Le Roy, IL 61752
Phone (309) 365-8608

1302 Franklin Ave
Ste 2500
Normal, IL 61761
Phone (309) 268-2727

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Ownership & related parties

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Carle Eureka HospitalEureka, IL, CCN 141309 Hospital Corporate Director Jan 1, 2021
Carle Eureka HospitalEureka, IL, CCN 14Z309 Hospital Corporate Director Jan 1, 2021
Carle Bromenn Medical CenterNormal, IL, CCN 14T127 Hospital Corporate Director Jan 1, 2021
Carle Bromenn Medical CenterNormal, IL, CCN 140127 Hospital Corporate Director Jan 1, 2021
Carle Eureka Family Medicine-EurekaEureka, IL, CCN 148581 Rural health clinic Corporate Director Jan 1, 2021
Carle Eureka Family Medicine - El PasoEl Paso, IL, CCN 148582 Rural health clinic Corporate Director Jan 1, 2021

Owned or controlled facilities with NPI records 6

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

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1285804724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 E EMPIRE ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617045402",
            "telephone_number": "309-556-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 E EMPIRE ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617045402",
            "telephone_number": "309-556-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "ANDREA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.120210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.