Individual provider Active NPI

John Phillip Cosgrove, D.O.

  • Family Medicine Physician
  • Kankakee, IL
National Provider Identifier
1669638425
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036131077 Issued in IL
Practice address
100 E Jeffery St
Kankakee, IL 60901-5018
Phone
(815) 939-8585
NPI assigned
Jul 31, 2008
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036131077 IL Primary

Addresses

Primary practice location

100 E Jeffery St
Kankakee, IL 60901-5018

Mailing address

100 E Jeffery St
Kankakee, IL 60901-5018
Phone (815) 939-8585

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
I20121026000301 IL Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 5496800393 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003551INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians to You Home Health Limited CurrentSince Jan 31, 2017 Accepting new patients
Osh-in Physicians Group, PC Family Medicine Past Accepting new patients
Vpa PC Family Medicine Past Accepting new patients
Broadway Medical Group Past Accepting new patients
Blue Island Clinic Company LLC Family Medicine Past Accepting new patients
Swedish Covenant Management Services, Inc Past Accepting new patients

Locations

6916 Cermak Rd
Berwyn, IL 60402
Phone (708) 933-3840

Interoperability endpoints

  • Direct secure messaging: john.cosgrove.1@4048.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1669638425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E JEFFERY ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609015018",
            "telephone_number": "815-939-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E JEFFERY ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609015018",
            "telephone_number": "815-939-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSGROVE",
        "first_name": "JOHN",
        "middle_name": "PHILLIP",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036131077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

Verify at the official NPI Registry.