Individual provider Active NPI

Hooshmond Kadkhodaian, M.D.

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1447233937
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036046530 Issued in IL
Practice address
2525 S Michigan Ave
Behavioral Health
Chicago, IL 60616-2333
Phone
(312) 562-2295
Fax
(312) 328-7808
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036046530 IL Primary

Addresses

Primary practice location

2525 S Michigan Ave
Behavioral Health
Chicago, IL 60616-2333

Mailing address

2525 S Michigan Ave
Behavioral Health
Chicago, IL 60616-2333
Phone (312) 567-2295

Other identifiers 2

IdentifierTypeStateIssuer
01621679OtherILBCBS OF IL
036046530MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Consultants of Chicago, LTD. Current Accepting new patients
Behavioral Health Care Associates LTD Psychiatry PastSince May 1, 1999 Accepting new patients
Lighthouse Consulting Services of Illinois Inc. Psychiatry PastSince Feb 4, 2016 Accepting new patients

Locations

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1447233937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "address_2": "BEHAVIORAL HEALTH",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162333",
            "telephone_number": "312-567-2295",
            "fax_number": "312-328-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "address_2": "BEHAVIORAL HEALTH",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162333",
            "telephone_number": "312-562-2295",
            "fax_number": "312-328-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADKHODAIAN",
        "first_name": "HOOSHMOND",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036046530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "01621679",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036046530",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.