Active NPI
Jeffery P Mendell, MD
- Diagnostic Radiology Physician
- Kankakee, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036113476
- Practice address
- 350 N Wall St
Kankakee, IL 60901-2991 - Phone
- (815) 933-1671
- NPI assigned
- May 17, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular & Interventional Radiology Physician | 2085R0204X | 036-113476 | IL | |
| Diagnostic Radiology Physician | 2085R0202X | 036113476 | IL | Primary |
Addresses
Primary practice location
350 N Wall St
Kankakee, IL 60901-2991
Mailing address
111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (309) 740-4272
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036113476 | Medicaid | IL | |
| 4615054 | Other | IL | BCBS ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Southern Illinois University School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 W Harlem Ave
Monmouth, IL 61462-1007
Phone (309) 734-1400
1051 W S St
Kewanee, IL 61443-8354
Phone (309) 852-7500
1100 E Norris Dr
Ottawa, IL 61350-1604
Phone (815) 433-3100
111 Spring St
Streator, IL 61364-3332
Phone (815) 673-2311
12701 W 143Rd St
Homer Glen, IL 60491-7715
Phone (708) 364-6337
1401 E 12TH St
Mendota, IL 61342-9216
Phone (815) 539-7461
1505 Eastland Dr
Bloomington, IL 61701-3636
Phone (309) 663-2100
1650 Midtown Rd
Peru, IL 61354-1200
Phone (815) 538-1351
17047 La Grange Rd
Orland Park, IL 60487-7227
Phone (815) 300-7764
1870 Silver Cross Blvd
Suite 150
New Lenox, IL 60451-8648
Phone (815) 300-1063
1900 Silver Cross Blvd
New Lenox, IL 60451-9509
Phone (815) 300-1100
2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 662-3311
2200 Fort Jesse Rd
Suite 100
Normal, IL 61761-6286
Phone (309) 661-6280
221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-5522
2406 E Empire St
Bloomington, IL 61704-3630
Phone (309) 664-3161
2406 Empire St
Bloomington, IL 61704-3630
Phone (309) 740-4272
2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 842-2828
2800 W 95TH St
Evergreen, IL 60805-2701
Phone (309) 740-4272
3315 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-1000
3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161
435 Maxine Dr
Morton, IL 61550-2498
Phone (309) 263-2424
500 W Romeo B Garrett Ave
Peoria, IL 61605-2301
Phone (309) 740-4272
5114 N Glen Park Place Rd
Peoria, IL 61614-4686
Phone (309) 683-2428
5200 Reliable Pkwy
Chicago, IL 60686-0052
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 740-4272
Hospital & facility affiliations
- Silver Cross Hospital and Medical Centers
- Saint Francis Medical Center
- Saint James Hospital
- Osf Saint Elizabeth MDL Ctr
- St Joseph Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-113476 | IL | MD | Vascular & Interventional Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Riverside Health System | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Central Illinois Radiological Associates, LTD. | Diagnostic Radiology | Current | Accepting new patients |
| Cira Michigan PC | Diagnostic Radiology | Current | Accepting new patients |
| Riverside Health System | Current | Accepting new patients | |
| Kankakee Radiology Associates, S.C. | Past | Accepting new patients |
Locations
300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666
5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748
1905 W Court St
Kankakee, IL 60901
Phone (815) 933-2240
401 N Wall St
Ste 205
Kankakee, IL 60901
Phone (815) 932-2541
350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500
530neglen Oak Ave
Peoria, IL 61636
Phone (309) 685-1054
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
114 W Stratford Dr
Ste E
Peoria, IL 61614
Phone (309) 740-4270
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
111 Oakwood Rd
Peoria, IL 61611
Phone (586) 412-4144
105 S First St
Wilmington, IL 60481
Phone (815) 476-5210
Organizations & group practices 7
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.
-
- Diagnostic Radiology Physician
- Peoria, IL
- NPI 1538192828
MO
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- General Practice Physician
- Kankakee, IL
- NPI 1417061193
-
- Psychiatry Physician
- Kankakee, IL
- NPI 1336354430
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
- Radiology Clinic/Center
- Kankakee, IL
- NPI 1346326139
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Peru, IL
- NPI 1588713440
-
- General Acute Care Hospital
- Pontiac, IL
- NPI 1407808090
-
- Rehabilitation Hospital Unit
- New Lenox, IL
- NPI 1003933797
-
- General Acute Care Hospital
- New Lenox, IL
- NPI 1568553519
-
- General Acute Care Hospital
- Bloomington, IL
- NPI 1619916806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701648000000",
"number": "1629285556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 OAKWOOD RD",
"city": "EAST PEORIA",
"state": "IL",
"postal_code": "616111853",
"telephone_number": "309-740-4272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 N WALL ST",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "609012991",
"telephone_number": "815-933-1671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDELL",
"first_name": "JEFFERY",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2023-12-04",
"certification_date": "2023-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "IL",
"license": "036-113476",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036113476",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036113476",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS ID",
"identifier": "4615054",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kankakee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.