Individual provider Active NPI

Kurt J Williams, M.D.

  • Cardiovascular Disease Physician
  • Geneva, IL
National Provider Identifier
1306833850
Registry record updated May 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036059197 Issued in IL
Practice address
351 Delnor Dr
Suite 100
Geneva, IL 60134-4220
Phone
(630) 232-0280
Fax
(630) 232-3895
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036059197 IL Primary

Addresses

Primary practice location

351 Delnor Dr
Suite 100
Geneva, IL 60134-4220

Mailing address

351 Delnor Dr
Suite 100
Geneva, IL 60134-4220
Phone (630) 232-0280

Other identifiers 4

IdentifierTypeStateIssuer
206147OtherILMEDICARE PTAN (GROUP)
036059197MedicaidIL
206147053OtherILMEDICARE PTAN (INDIVIDUAL)
P00931953OtherILRR MEDICARE PTAN (INDIVIDUAL)

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
I20090724000612 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9234032228 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Winfield Pathology Consultants, S.C. Current Accepting new patients
Central Dupage Hospital Association CurrentSince Aug 1, 2009 Accepting new patients
Central Dupage Hospital Association CurrentSince Aug 1, 2009 Accepting new patients
Delnor Community Hospital CurrentSince Jan 1, 1980 Accepting new patients

Locations

Dept 4698
Carol Stream, IL 60122

300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009

302 Randall Rd
Ste 304
Geneva, IL 60134
Phone (630) 208-6775

304 Randall Rd
Geneva, IL 60134
Phone (630) 232-0610

302 Randall Rd
Ste 106
Geneva, IL 60134
Phone (630) 232-7200

351 Delnor Dr
Ste 312
Geneva, IL 60134
Phone (630) 208-4460

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336953600000",
    "number": "1306833850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 DELNOR DR",
            "address_2": "SUITE 100",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344220",
            "telephone_number": "630-232-0280",
            "fax_number": "630-232-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 DELNOR DR",
            "address_2": "SUITE 100",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344220",
            "telephone_number": "630-232-0280",
            "fax_number": "630-232-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KURT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2012-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036059197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "206147",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036059197",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "206147053",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "P00931953",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.