NPIMap

Organization Active NPI

Kirill Zhadovich, M.D., S.C.

  • Primary Care Clinic/Center
  • Niles, IL
National Provider Identifier
1659556546
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
KIRILL ZHADOVICH, M.D., S.C.
Practice address
7900 N Milwaukee Ave
Suite 2-24
Niles, IL 60714-3159
Phone
(847) 825-0800
Fax
(847) 825-0803
NPI assigned
Jan 9, 2008
Last updated
Mar 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Authorized official

Name
Kirill Zhadovich, M.D.NPI 1003881699
Title
President
Phone
(847) 825-0800

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

7900 N Milwaukee Ave
Suite 2-24
Niles, IL 60714-3159

Mailing address

PO Box 2056
Northbrook, IL 60065-2056
Phone (847) 825-0800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050901000141 IL Part B Supplier - Clinic/Group Practice 3072545896 Receives reassigned benefits from 9 practitioners
Practice locations: Niles, IL

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBGFBA

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1659556546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2056",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600652056",
            "telephone_number": "847-825-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 N MILWAUKEE AVE",
            "address_2": "SUITE 2-24",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143159",
            "telephone_number": "847-825-0800",
            "fax_number": "847-825-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRILL ZHADOVICH, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "ZHADOVICH",
        "authorized_official_first_name": "KIRILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-825-0800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.