Individual provider Active NPI

T K Venkatesan, M.D.

  • Otolaryngology Physician
  • Chicago, IL
National Provider Identifier
1295797470
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036088143 Issued in IL
Practice address
30 N Michigan Ave
#1107
Chicago, IL 60602-3402
Phone
(312) 236-3642
Fax
(312) 236-5162
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 036088143 IL Primary

Addresses

Primary practice location

30 N Michigan Ave
#1107
Chicago, IL 60602-3402

Mailing address

PO Box 809094
Chicago, IL 60680-9094
Phone (312) 236-3642

Other identifiers 1

IdentifierTypeStateIssuer
036088143MedicaidIL

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
I20100730000573 IL Practitioner - Otolaryngology 9133252950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Head and Neck Cosmetic Surgery Associates LLCGroup PAC ID 2264476118, 22 clinicians

Practice addresses (Care Compare)

2233 W Division St
Chicago, IL 60622-8151
Phone (312) 770-2000

2845 N Sheridan Rd
Suite 807
Chicago, IL 60657-7227
Phone (773) 296-5500

3000 N Halsted St
Suite 400
Chicago, IL 60657-8480
Phone (773) 296-5500

331 W Surf St
Chicago, IL 60657-7227
Phone (773) 739-2694

Hospital & facility affiliations

  • Presence Saints Mary and Elizabeth Medical Center Hospital, Chicago, IL, CCN 140180
  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
  • Presence Saint Joseph Hospital - Chicago Hospital, Chicago, IL, CCN 140224

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036088143ILMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Head & Neck Cosmetic Surgery Associates LLC Otolaryngology CurrentSince Jul 1, 2001 Accepting new patients
Presence Healthcare Services Past Accepting new patients

Locations

30 N Michigan Ave
Ste 1107
Chicago, IL 60602
Phone (312) 236-3642

30 N Michigan Ave
#1107
Chicago, IL 60602
Phone (312) 236-3642

2222 W Division St
Ste 330
Chicago, IL 60622
Phone (773) 227-0111

3000 N Halsted St
Ste 400
Chicago, IL 60657
Phone (773) 296-5500

2522 W Peterson Ave
Chicago, IL 60659
Phone (773) 262-4110

Interoperability endpoints

  • Direct secure messaging: tk.venkatesan.1@3547.direct.athenahealth.com
  • Direct secure messaging: tk.venkatesan@hncsa.eclinicaldirectplus.com

Organizations & group practices 2

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 3

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1295797470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 809094",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606809094",
            "telephone_number": "312-236-3642",
            "fax_number": "312-236-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "#1107",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023402",
            "telephone_number": "312-236-3642",
            "fax_number": "312-236-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKATESAN",
        "first_name": "T",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036088143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088143",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.