Individual provider Active NPI

Nha T Huynh, DO

  • Cardiovascular Disease Physician
  • Kankakee, IL
National Provider Identifier
1376709758
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036126723 Issued in IL
Practice address
500 N Wall St
Kankakee, IL 60901-2942
Phone
(844) 404-4787
Fax
(815) 936-3243
NPI assigned
Aug 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036126723 IL
Cardiovascular Disease Physician 207RC0000X 036126723 IL Primary

Addresses

Primary practice location

500 N Wall St
Kankakee, IL 60901-2942

Mailing address

500 N Wall St
Kankakee, IL 60901-2942
Phone (844) 404-4787

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nhuynh13925@Direct.riversidehealthcare.net Direct

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
I20110610000238 IL Practitioner - Cardiovascular Disease (Cardiology) 3375720899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Health System 202 clinicians

Practice addresses (Care Compare)

105 S 1St St
Willmington, IL 60481-8973
Phone (815) 476-5210

23120 S Lagrange Rd
Suite 200
Frankfort, IL 60423-7760
Phone (815) 464-5440

350 N Wall St 4TH Floor
Kankakee, IL 60901-2901
Phone 81593316714592

400 Riverside Dr
Suite 2800
Bourbonnais, IL 60914-5004
Phone (815) 935-1100

500 N Wall St
Kankakee, IL 60901-2942

500 N Wall Ste
Suite 200
Kankakee, IL 60901-2942
Phone (815) 937-1237

5775 E State Route 113
Coal City, IL 60416-7111
Phone (815) 634-0100

611 Division St
Peotone, IL 60468-9590
Phone (708) 258-9058

Hospital & facility affiliations

  • Riverside Medical Center Hospital, Kankakee, IL, CCN 140186
  • Iroquois Memorial Hospital Hospital, Watseka, IL, CCN 141353

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036126723ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Health System CurrentSince Aug 29, 2016 Accepting new patients
Riverside Health System Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

500 N Wall St
Kankakee, IL 60901
Phone (815) 937-9300

500 N Wall St
Ste C100
Kankakee, IL 60901
Phone (844) 404-4787

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

611 S Division St
Peotone, IL 60468
Phone (708) 258-9058

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

Interoperability endpoints

  • Direct secure messaging: nhuynh13925@direct.riversidehealthcare.net

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 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": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1376709758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012942",
            "telephone_number": "844-404-4787",
            "fax_number": "815-936-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012942",
            "telephone_number": "844-404-4787",
            "fax_number": "815-936-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "NHA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036126723",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036126723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nhuynh13925@Direct.riversidehealthcare.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 N Wall St",
            "city": "Kankakee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609012942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

Verify at the official NPI Registry.