Kishwaukee Physician Group, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

KISHWAUKEE PHYSICIAN GROUP, INC.

Practice address

1850 Gateway Dr
Sycamore, IL 60178-3192

Phone

(815) 758-8671

NPI assigned

Feb 26, 2016

Last updated

Apr 13, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Christine Zydek

Title

Director of Finance

Phone

(815) 748-2986

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8426/brand/1/csg/1/fhir/r4

Practitioners 2

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.

• Syeda Ali, MD

  • Family Medicine Physician
  • Aurora, IL
  • NPI 1265732176
  NPD (past)
• James Patrick Ford, D.P.M.

  • Podiatrist
  • Oak Park, IL
  • NPI 1376594473
  NPD (past)

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523577600000",
    "number": "1679933139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 487",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601150487",
            "telephone_number": "815-758-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 GATEWAY DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783192",
            "telephone_number": "815-758-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISHWAUKEE PHYSICIAN GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2018-04-13",
        "status": "A",
        "authorized_official_last_name": "ZYDEK",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "815-748-2986",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kishwaukee Cardiology Associates, LTD
• Kishwaukee Cardiology Associates, LTD.
• Kishwaukee Community Health Services Center (Hauser-Ross Surgicenter)
• Kishwaukee Corporate Health @Moi
• Kishwaukee Internist SC
• Jennifer L. Kleckner, RN, IBCLC
• Collette Ann Klein, RN MSN FPMHNP-BC
• Kevin Kloosterman, M.S., LMFT
• KND Development 59 LLC
• Mary Knepp

• Durable Medical Equipment & Medical Supplies in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.