Individual provider Active NPI

Nidhi Kansal, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1396034484
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036135615 Issued in IL
Practice address
676 N St Clair
Suite 2300
Chicago, IL 60611-2922
Phone
(312) 926-6000
Fax
(312) 926-5971
NPI assigned
Mar 30, 2011
Last updated
May 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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 125060483 IL
Internal Medicine Physician 207R00000X 036135615 IL Primary

Addresses

Primary practice location

676 N St Clair
Suite 2300
Chicago, IL 60611-2922

Mailing address

259 E Erie St
Suite 2230
Chicago, IL 60611-2987
Phone (312) 926-6000

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
I20140827002481 IL Practitioner - Internal Medicine 0941428296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Indiana University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1135 S Delano CT E
Chicago, IL 60605-3457
Phone (630) 933-1500

1135 W Delano CT
A201
Chicago, IL 60605-3457
Phone (312) 695-0665

1333 W Belmont Ave
Chicago, IL 60657-5785

2701 Patriot Blvd
Glenview, IL 60026-8039
Phone (847) 998-9910

4445 W Irving Park Rd
Chicago, IL 60641-2808

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

885 Roosevelt Rd
Glen Ellyn, IL 60137-6141

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

State licenses

LicenseStateTypeSpecialty
125060483ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2014 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2014 Accepting new patients
Central Dupage Physician Group Internal Medicine Past Accepting new patients
Chicago Lake Shore Medical Associates,LTD Internal Medicine PastSince Jun 25, 2007 Accepting new patients

Locations

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

Dept 5777
Carol Stream, IL 60122

259 E Erie St
Ste 2230
Chicago, IL 60611

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1396034484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST",
            "address_2": "SUITE 2230",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-926-6000",
            "fax_number": "312-926-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N ST CLAIR",
            "address_2": "SUITE 2300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112922",
            "telephone_number": "312-926-6000",
            "fax_number": "312-926-5971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANSAL",
        "first_name": "NIDHI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-30",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125060483",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036135615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.