Active NPI
Ann E Kinnealey MD PC
- Hematology & Oncology Physician
- Evanston, IL
National Provider Identifier
1588659130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 036050081
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036050081 | Medicaid | IL |
National Provider Directory
National Provider DirectoryLocations
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.