Organization Active NPI

Ann E Kinnealey MD PC

  • Hematology & Oncology Physician
  • Evanston, IL
National Provider Identifier
1588659130
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036050081 Issued in IL
Legal business name
ANN E KINNEALEY MD PC
Practice address
800 Austin St
Ste 557
Evanston, IL 60202-3439
Phone
(847) 869-2076
Fax
(847) 475-3414
NPI assigned
Sep 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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

Authorized official

Name
Mrs. Ann Elizabeth Kinnealey, MD
Title
Oncologist
Phone
(847) 869-2076

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X 036050081 IL Primary

Addresses

Primary practice location

800 Austin St
Ste 557
Evanston, IL 60202-3439

Mailing address

9266 Paysphere Circle
Chicago, IL 60674-0052
Phone (847) 869-2076

Other identifiers 1

IdentifierTypeStateIssuer
036050081MedicaidIL

National Provider Directory

National Provider Directory

Locations

9266 Paysphere Cir
Chicago, IL 60674

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225929600000",
    "number": "1588659130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9266 PAYSPHERE CIRCLE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740052",
            "telephone_number": "847-869-2076",
            "fax_number": "847-475-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST",
            "address_2": "STE 557",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023439",
            "telephone_number": "847-869-2076",
            "fax_number": "847-475-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN E KINNEALEY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2008-11-06",
        "status": "A",
        "authorized_official_last_name": "KINNEALEY",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "ONCOLOGIST",
        "authorized_official_telephone_number": "847-869-2076",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036050081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036050081",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; 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.