Individual provider Active NPI

Kristin W Houseknecht, M.D.

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Chicago, IL
National Provider Identifier
1538489869
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
036.142542 Issued in IL
Practice address
614 W Monroe St
Chicago, IL 60661-3654
Phone
(312) 258-0700
NPI assigned
Jun 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME108909 FL
General Practice Physician 208D00000X 01077086A IN
Student in an Organized Health Care Education/Training Program 390200000X TRN14997 FL
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 036.142542 IL Primary

Addresses

Primary practice location

614 W Monroe St
Chicago, IL 60661-3654

Mailing address

1074 W Taylor St Unit 319
Chicago, IL 60607-4336
Phone (813) 495-2785

Other identifiers 2

IdentifierTypeStateIssuer
000001052783OtherINANTHEM
201398420MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20161121000673 IN Practitioner - General Practice 9830342609 Reassigns benefits to 1 organization
I20180509002046 IL Practitioner - General Practice 9830342609 Reassigns benefits to 1 organization
I20260529003301 IL Practitioner - Preventive Medicine 9830342609

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of South Florida College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10137 Grand Ave
Franklin Park, IL 60131-2548
Phone (847) 451-7590

1030 W Chicago Ave
Chicago, IL 60642-5671
Phone (312) 243-1574

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.142542ILMDPreventive Medicine/Occupational Environmental Medicine Physician
TRN14997FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA CurrentSince Oct 7, 2019 Accepting new patients
American Current Care of Illinois PC CurrentSince May 21, 2018 Accepting new patients
American Current Care P.a. CurrentSince Oct 7, 2019 Accepting new patients

Locations

614 W Monroe St
Chicago, IL 60661
Phone (312) 258-0700

10137 Grand Ave
Franklin Park, IL 60131
Phone (847) 451-7590

6423 Columbia Ave
Ste A
Hammond, IN 46320
Phone (219) 937-3632

5604 W 74th St
Indianapolis, IN 46278
Phone (317) 290-1551

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

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": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1538489869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1074 W TAYLOR ST UNIT 319",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074336",
            "telephone_number": "813-495-2785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 W MONROE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606613654",
            "telephone_number": "312-258-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSEKNECHT",
        "first_name": "KRISTIN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-09",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME108909",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01077086A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN14997",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "IL",
            "license": "036.142542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000001052783",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201398420",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.