NPIMap

Individual provider Active NPI

Sampath P Kumar, MD

  • Infectious Disease Physician
  • Crestwood, IL
National Provider Identifier
1386630622
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
036-096960 Issued in IL
Practice address
13755 Cicero Ave
Crestwood, IL 60445-1824
Phone
(888) 220-6432
Fax
(708) 385-7840
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 036-096960 IL Primary

Addresses

Primary practice location

13755 Cicero Ave
Crestwood, IL 60445-1824

Mailing address

901 McClintock Dr
Suite 202
Burr Ridge, IL 60527-0872
Phone (888) 220-6432

Other identifiers 1

IdentifierTypeStateIssuer
036-096-960MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100311000467 IL Practitioner - Infectious Disease 1052456340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

13755 Cicero Ave
Crestwood, IL 60418-1824
Phone (888) 220-6432

Hospital & facility affiliations

  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Osf Little Company of Mary Medical Center Hospital, Evergreen Park, IL, CCN 140179
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-096960ILMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Infectious Disease Consultants, LLC Infectious Disease CurrentSince Apr 23, 2002 Accepting new patients
Metro Infectious Disease Consultants LLC Infectious Disease CurrentSince Apr 23, 2002 Accepting new patients
Southwest Infectious Disease & Internal Medicine S C Infectious Disease Past Accepting new patients

Locations

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

13755 Cicero Ave
Crestwood, IL 60418
Phone (708) 385-2400

1300 Franklin Ave
Ste 230C
Normal, IL 61761
Phone (309) 585-6029

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 7

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1386630622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MCCLINTOCK DR",
            "address_2": "SUITE 202",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270872",
            "telephone_number": "888-220-6432",
            "fax_number": "630-654-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13755 CICERO AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604451824",
            "telephone_number": "888-220-6432",
            "fax_number": "708-385-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "SAMPATH",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036-096960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-096-960",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestwood, IL

Sources for this page

Verify at the official NPI Registry.