Kenneth N Cline, M.D.
Individual provider Active NPI Nephrology Physician · Flossmoor, IL
NPI 1508961517 · NPPES record last updated Mar 25, 2008
Key facts
- NPI
- 1508961517
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- Practice address
- 19550 Governors Hwy
Suite 2000
Flossmoor, IL 60422-2125 - Phone
- (708) 957-8750
- Fax
- (708) 957-8602
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Nephrology
- Education
- Illinois Medical College, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ucm Medical Group Sub LLC
Practice addresses (Care Compare)
1 Ingalls Dr
Harvey, IL 60426-3558
Phone (708) 333-2300
19550 Governors Hwy
Suite 3000
Flossmoor, IL 60422-2150
Phone (708) 915-8660
Hospital & facility affiliations
- DaVita South Holland Renal Center
- FMC - South Suburban
- DaVita Country Hills Dialysis
- FMC - Steger Dialysis
- DaVita Hazel Crest Renal Center
- Ingalls Memorial Hospital
- Advocate Trinity Hospital
- The University of Chicago Medical Center
- Franciscan Health Olympia & Chicago Heights
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051209000339 | IL | Practitioner - Nephrology |
1951322684 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036082816 | IL | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ucm Medical Group Sub, LLC | Current |
Accepting new patients |
Locations
150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061
27702 Network Pl
Chicago, IL 60673
19550 Governors Hwy
Flossmoor, IL 60422
Phone (708) 799-8400
19550 Governors Hwy
Ste 2000
Flossmoor, IL 60422
Phone (708) 272-6606
1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300
Interoperability endpoints
- kcline202152@uchospital.direct-ci.com
- kcline5980@direct.franciscanalliance.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | IL | Yes |
Addresses
Primary practice location
19550 Governors Hwy
Suite 2000
Flossmoor, IL 60422-2125
Mailing address
19550 Governors Hwy
Suite 2000
Flossmoor, IL 60422-2125
Phone (708) 957-8750
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110163534/CA4448 | Other | IL | RAILROAD PALMETTO GBA |
Other providers in Flossmoor, IL
- May J Chow
- Donna Christie
- Thomas Tzi-Chorng Chung
- Shane Clausell
- Shelena Clay
- CLS Comprehensive Services, LLC
- Collabcore
- Melinda A Collins
- Sandra K. Collins
- Sean Collins
All providers in Flossmoor, IL · Nephrology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.