Individual provider Active NPI

Kevin O'Brien, MD

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1346686474
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036139521 Issued in IL
Practice address
7435 W Talcott Ave
Chicago, IL 60631-3707
Phone
(773) 792-5261
NPI assigned
May 15, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 036139521 IL Primary

Addresses

Primary practice location

7435 W Talcott Ave
Chicago, IL 60631-3707

Mailing address

2650 Ridge Ave.
Dept. of Radiology
Evanston, IL 60201-1718
Phone (847) 570-2475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20190514000171 IN Practitioner - Diagnostic Radiology 9537461397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Cincinnati College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology IncGroup PAC ID 5890695464, 35 clinicians

Practice addresses (Care Compare)

100 Navarre PL
Suite 5510
South Bend, IN 46601-1172
Phone (574) 647-7742

100 Navarre PL
Suite 6655
South Bend, IN 46601-1174
Phone (574) 647-6850

1010 W State Rd
Suite 2
La Porte, IN 46350-5465
Phone (574) 258-1100

1020 High Rd
Bremen, IN 46506-1093
Phone (574) 546-2211

1033 N Indiana Ave
Syracuse, IN 46567-1017
Phone (574) 457-5701

1115 Professional Dr
Goshen, IN 46526-3800
Phone (574) 364-4850

1135 Professional Dr
Goshen, IN 46526-3800
Phone (574) 364-4000

14043 Kline Shores Dr
Granger, IN 46530-1359
Phone (574) 258-1100

200 High Park Ave
Goshen, IN 46526-4810
Phone (574) 535-2693

303 S Nappanee St
Elkhart Clinic
Elkhart, IN 46514-2066
Phone (574) 296-3365

4200 Winter LN
Dr. Ahmad'S Home
Valparaiso, IN 46385-6306
Phone (574) 258-1100

600 E Blvd
Elkhart, IN 46514-2483
Phone (574) 294-2621

615 N Michigan St
Memorial Hospital
South Bend, IN 46601-1033
Phone (574) 647-1000

6901 N Main St
Memorial Lighthouse Imaging Center
Granger, IN 46530-8022
Phone (574) 647-2900

Hospital & facility affiliations

  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
  • Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018
  • Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015
  • Goshen Hospital Hospital, Goshen, IN, CCN 150026
  • Three Rivers Health Hospital, Three Rivers, MI, CCN 230015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036139521ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Health, LLC Diagnostic Radiology CurrentSince Aug 8, 2022 Accepting new patients
Radiology, Inc Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients
Beacon Health, LLC Diagnostic Radiology CurrentSince Mar 23, 2026 Accepting new patients

Locations

1020 High Rd
#O
Bremen, IN 46506
Phone (574) 284-3086

303 S Nappanee St
Elkhart, IN 46514

600 East Blvd
Elkhart, IN 46514
Phone (574) 294-2621

200 High Park Ave
Goshen, IN 46526
Phone (219) 533-2141

1135 Professional Dr
Goshen, IN 46526
Phone (574) 364-4600

1115 Professional Dr
Goshen, IN 46526
Phone (574) 364-4850

102 E Culver Rd
Knox, IN 46534
Phone (574) 772-1580

620 W Edison Rd
Ste 110
Mishawaka, IN 46545
Phone 5742581100 ext. 239

100 Navarre Pl
Ste 5500
South Bend, IN 46601
Phone (574) 647-5200

100 Navarre Pl
Ste 6655
South Bend, IN 46601
Phone (574) 284-6850

615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000

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 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": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1346686474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "DEPT. OF RADIOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313707",
            "telephone_number": "773-792-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-15",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036139521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.