Individual provider Active NPI

Manan Dhingra, MD

  • Rheumatology Physician
  • Kankakee, IL
National Provider Identifier
1679099626
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036172994 Issued in IL
Practice address
375 N Wall St Ste P320
Kankakee, IL 60901-3490
Phone
(815) 928-5064
Fax
(815) 928-5065
NPI assigned
Aug 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TEP8082 NE
Rheumatology Physician 207RR0500X 036172994 IL Primary

Addresses

Primary practice location

375 N Wall St Ste P320
Kankakee, IL 60901-3490

Mailing address

375 N Wall St Ste P320
Kankakee, IL 60901-3490
Phone (815) 928-5064

Other practice location 1

38 Olympus Dr
Tinley Park, IL 60477-4829
Phone (630) 408-1350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221005001090 WI Practitioner - Rheumatology 3274957782 Reassigns benefits to 1 organization
I20250213001238 IL Practitioner - Rheumatology 3274957782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

105 S 1St St
Willmington, IL 60481-8973
Phone (815) 476-5210

375 N Wall St
P520
Kankakee, IL 60901-3493
Phone (815) 933-0194

5775 E State Route 113
Coal City, IL 60416-7111
Phone (815) 634-0100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TEP8082NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc Internal Medicine CurrentSince Sep 19, 2022 Accepting new patients
Riverside Health System CurrentSince Jan 9, 2025 Accepting new patients
Riverside Health System CurrentSince Jan 9, 2025 Accepting new patients

Locations

300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666

375 N Wall St
Ste P320
Kankakee, IL 60901
Phone (815) 928-5064

375 N Wall St
Ste 320
Kankakee, IL 60901

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

201 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 259-7200

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1679099626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 N WALL ST STE P320",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013490",
            "telephone_number": "815-928-5064",
            "fax_number": "815-928-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 N WALL ST STE P320",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013490",
            "telephone_number": "815-928-5064",
            "fax_number": "815-928-5065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38 Olympus Dr",
            "address_purpose": "LOCATION",
            "city": "Tinley Park",
            "state": "IL",
            "postal_code": "604774829",
            "country_code": "US",
            "telephone_number": "630-408-1350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DHINGRA",
        "first_name": "MANAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-21",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "TEP8082",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036172994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

Verify at the official NPI Registry.