NPIMap

Organization Active NPI

Warren Kammerer MD SC

  • Psychiatry Physician
  • Park Ridge, IL
National Provider Identifier
1578725479
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036077883 Issued in IL
Legal business name
WARREN KAMMERER MD SC
Practice address
1440 Renaissance Dr
Suite 200
Park Ridge, IL 60068-1472
Phone
(847) 296-3442
Fax
(847) 296-3543
NPI assigned
Jul 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Authorized official

Name
Dr. Warren Louis Kammerer III, MDNPI 1134236565
Title
President
Phone
(847) 296-3442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychosomatic Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0015X 036077883 IL
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X 036077883 IL Primary

Addresses

Primary practice location

1440 Renaissance Dr
Suite 200
Park Ridge, IL 60068-1472

Mailing address

1440 Renaissance Dr
Suite 200
Park Ridge, IL 60068-1472
Phone (847) 296-3442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080919000099 IL Part B Supplier - Clinic/Group Practice 8527135383 Receives reassigned benefits from 1 practitioner
Practice locations: Park Ridge, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1578725479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR",
            "address_2": "SUITE 200",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681472",
            "telephone_number": "847-296-3442",
            "fax_number": "847-296-3543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR",
            "address_2": "SUITE 200",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681472",
            "telephone_number": "847-296-3442",
            "fax_number": "847-296-3543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN KAMMERER MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "KAMMERER",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-296-3442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "IL",
            "license": "036077883",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036077883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.