Individual provider Active NPI

Bryan Killian

  • Family Medicine Physician
  • Grayslake, IL
National Provider Identifier
1336670181
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036152467 Issued in IL
Practice address
1475 E Belvidere Rd
Grayslake, IL 60030-2012
Phone
(312) 926-0106
Fax
(312) 694-0655
NPI assigned
Mar 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036152467 IL Primary

Addresses

Primary practice location

1475 E Belvidere Rd
Grayslake, IL 60030-2012

Mailing address

1333 W Belmont Ave Ste 200
Chicago, IL 60657-5785
Phone (312) 926-3627

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
I20200908003079 IL Practitioner - Family Practice 7416292115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1333 W Belmont Ave
Suite 200
Chicago, IL 60657-5785
Phone (312) 926-6146

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2020 Accepting new patients
Central Dupage Physician Group Family Medicine Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

1333 W Belmont Ave
Ste 200
Chicago, IL 60657
Phone (773) 248-5009

1475 E Belvidere Rd
Grayslake, IL 60030
Phone (847) 535-8800

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1336670181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 W BELMONT AVE STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575785",
            "telephone_number": "312-926-3627",
            "fax_number": "312-694-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 E BELVIDERE RD",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302012",
            "telephone_number": "312-926-0106",
            "fax_number": "312-694-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLIAN",
        "first_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036152467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayslake, IL

Sources for this page

Verify at the official NPI Registry.