Peter W Kakavas, M.D.
Individual provider Active NPI Cardiovascular Disease Physician · Palos Park, IL
NPI 1528022191 · NPPES record last updated Sep 4, 2020
Key facts
- NPI
- 1528022191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 036083840 (IL)
- Practice address
- 13011 S 104TH Ave Ste 100
Palos Park, IL 60464-1508 - Phone
- (708) 274-3278
- Fax
- (708) 274-3299
- NPI assigned
- Apr 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Loyola University of Chicago, Stritch School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Heart Care Centers of Illinois, S.C.
Practice addresses (Care Compare)
10260 191St St
Suite 102
Mokena, IL 60448-8802
Phone (708) 478-4224
13011 S 104TH Ave
Suite 100
Palos Park, IL 60464-1508
Phone (708) 274-3278
3231 Euclid Ave
Suite 201
Berwyn, IL 60402-3472
Phone (708) 783-2055
4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-5509
Heart Care Centers of Illinois SC
13011 S 104TH Avenue Suite 100
Palos Park, IL 60464-1508
Hospital & facility affiliations
- Palos Community Hospital
- Advocate Christ Hospital & Medical Center
- Silver Cross Hospital and Medical Centers
- Northwestern Medicine Central Dupage Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 46 |
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 |
|---|---|---|---|---|
| I20040501000259 | IL | Practitioner - Cardiovascular Disease (Cardiology) | 4284536780 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036083840 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventist Bolingbrook Hospital | Cardiovascular Disease | Current |
Accepting new patients |
| Adventist Bolingbrook Hospital | Current |
Accepting new patients | |
| Heart Care Centers of Illinois, SC | Internal Medicine | Current |
Accepting new patients |
| Uropartners, LLC | Past | Accepting new patients | |
| VHS of Illinois Inc | Internal Medicine | Past | Accepting new patients |
Locations
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
3231 Euclid Ave
Ste 400
Berwyn, IL 60402
Phone (708) 478-3600
2338 New St
Blue Island, IL 60406
Phone (708) 577-5060
500 Remington Blvd
Bolingbrook, IL 60440
Phone (630) 312-5000
2121 Oneida St
Ste 202
Joliet, IL 60435
Phone (815) 741-4390
500 N Wall St
Kankakee, IL 60901
Phone (815) 937-9300
19001 Old Lagrange Rd
Mokena, IL 60448
Phone (708) 478-3600
10260 191st St
Ste 102
Mokena, IL 60448
Phone (708) 478-4224
13011 S 104th Ave
Ste 100
Palos Park, IL 60464
Phone (708) 274-3278
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036083840 | IL | |
| Cardiovascular Disease Physician | 207RC0000X | 036083840 | IL | Yes |
Addresses
Primary practice location
13011 S 104TH Ave Ste 100
Palos Park, IL 60464-1508
Mailing address
13011 S 104TH Ave Ste 100
Palos Park, IL 60464-1508
Phone (708) 478-3600
Other practice location 1
19001 Old Lagrange Rd
Mokena, IL 60448-8012
Phone (708) 478-4224
Other practice location 2
10260 191st St Ste 102
Mokena, IL 60448-8802
Phone (708) 478-4224
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01621208 | Other | IL | BLUECROSS BLUESHIELD |
| 416810 | Other | IL | MEDICARE GROUP |
| CD8033 | Other | IL | RAILROAD MEDICARE GROUP PTAN NUMBER |
| 236551 | Other | IL | MEDICARE GROUP |
| CG1672 | Other | IL | RAILROAD MEDICARE GROUP PTAN NUMBER |
| CN2703 | Other | IL | RAILROAD MEDICARE GROUP PTAN NUMBER |
| 01621208 | Other | IL | BLUE CROSS BLUE SHIELD GROUP NUMBER |
| 060047092 | Other | IL | RAILROAD MEDICARE WILL |
| 1508810086 | Other | IL | HEART CARE CENTERS OF ILLINOIS GROUP NPI |
| 036083840 | Medicaid | IL | |
| 060047092 | Other | IL | RAILROAD MEDICARE COOK |
| 060056850 | Other | IL | RAILROAD MEDICARE KANKAKE |
| 236550 | Other | IL | MEDICARE GROUP |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pkakavas-sm@heartcc.com |
Other providers in Palos Park, IL
- Jadan Group LTD
- Francis P Jamilla
- Giedre Jaskevicius
- Hiyam Jhane
- Julie A Johnson
- Kalem Therapy PLLC
- Michael Eugene Kaplan
- Thomas Theodore Kason
- Kemet Chiropractic & Wellness, S.C.
- Adrianne Kenny
All providers in Palos Park, IL · Cardiovascular Disease 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 Sep 4, 2020. 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.