NPIMap

Individual provider Active NPI

Sreepathy Kannan, M.D.

  • Neurology Physician
  • Orland Park, IL
National Provider Identifier
1295793529
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036.115847 Issued in IL
Practice address
18327 Distinctive Dr
Orland Park, IL 60467-9461
Phone
(708) 675-7110
Fax
(708) 310-3430
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036.115847 IL Primary

Addresses

Primary practice location

18327 Distinctive Dr
Orland Park, IL 60467-9461

Mailing address

8S323 Hampton Cir
Naperville, IL 60540-9322
Phone (708) 675-7110

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
I20060814000174 IL Practitioner - Neurology 0547263584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18327 Distinctive Dr
Orland Park, IL 60467-9461
Phone (815) 768-2210

Hospital & facility affiliations

  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213
  • Uchicago Medicine Adventhealth Bolingbrook Hospital, Bolingbrook, IL, CCN 140304
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Brain and Nerve Disorders S.C. Neurology CurrentSince Aug 6, 2013 Accepting new patients

Locations

18327 Distinctive Dr
Orland Park, IL 60467
Phone (708) 675-7110

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 8

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1295793529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8S323 HAMPTON CIR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605409322",
            "telephone_number": "708-675-7110",
            "fax_number": "708-310-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18327 DISTINCTIVE DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679461",
            "telephone_number": "708-675-7110",
            "fax_number": "708-310-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNAN",
        "first_name": "SREEPATHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036.115847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.