Individual provider Active NPI

Snigdha Kalidindi

  • Sports Medicine (Family Medicine) Physician
  • Bourbonnais, IL
National Provider Identifier
1417535477
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
036.170177 Issued in IL
Practice address
100 Riverside Dr
Bourbonnais, IL 60914-4607
Phone
(815) 802-7090
Fax
(815) 802-7091
NPI assigned
Mar 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036170177 IL
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Family Medicine) Physician 207QS0010X 036.170177 IL Primary

Addresses

Primary practice location

100 Riverside Dr
Bourbonnais, IL 60914-4607

Mailing address

100 Riverside Dr
Bourbonnais, IL 60914-4607
Phone (815) 802-7090

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
I20260128003315 IL Practitioner - Sports MedicinePractitioner - Family Practice 8022427780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Riverside Medical Center Hospital, Kankakee, IL, CCN 140186

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036170177ILMDFamily Medicine Physician
036.170177ILMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Health System CurrentSince Jan 16, 2026 Accepting new patients
Riverside Health System Past Accepting new patients

Locations

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

Organizations & group practices 2

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 1

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": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1417535477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIVERSIDE DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144607",
            "telephone_number": "815-802-7090",
            "fax_number": "815-802-7091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIVERSIDE DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144607",
            "telephone_number": "815-802-7090",
            "fax_number": "815-802-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALIDINDI",
        "first_name": "SNIGDHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036170177",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036.170177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

Verify at the official NPI Registry.