Individual provider Active NPI

Katherine Nancy Kamholz, M.D.

  • Internal Medicine Physician
  • Fox River Grove, IL
National Provider Identifier
1629062849
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036095547 Issued in IL
Practice address
912 Northwest Hwy Ste 107
Fox River Grove, IL 60021-1925
Phone
(847) 462-5100
NPI assigned
Sep 2, 2005
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036095547 IL Primary

Addresses

Primary practice location

912 Northwest Hwy Ste 107
Fox River Grove, IL 60021-1925

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

509 W Old Northwest Hwy
Suite 100C
Barrington, IL 60010-6811
Phone (847) 756-7360

Other identifiers 1

IdentifierTypeStateIssuer
036095547MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kkamholz237900@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060306000065 IL Practitioner - Internal Medicine 8628084415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Southern Illinois University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

912 Northwest Hwy
Suite 107
Fox River Grove, IL 60021-1925
Phone (847) 462-5100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036095547ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jul 1, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 1, 2024 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Internal Medicine Associates SC Internal Medicine Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

912 Northwest Hwy
Ste 107
Fox River Grv, IL 60021
Phone (847) 462-5100

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1629062849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 NORTHWEST HWY STE 107",
            "city": "FOX RIVER GROVE",
            "state": "IL",
            "postal_code": "600211925",
            "telephone_number": "847-462-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 W Old Northwest Hwy",
            "address_2": "Suite 100C",
            "address_purpose": "LOCATION",
            "city": "Barrington",
            "state": "IL",
            "postal_code": "600106811",
            "country_code": "US",
            "telephone_number": "847-756-7360",
            "fax_number": "847-277-7191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMHOLZ",
        "first_name": "KATHERINE",
        "middle_name": "NANCY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-02",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036095547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095547",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkamholz237900@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "912 Northwest Hwy Ste 107",
            "city": "Fox River Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600211925",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "912 Northwest Hwy Ste 107",
            "city": "Fox River Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600211925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fox River Grove, IL

Sources for this page

Verify at the official NPI Registry.