Individual provider Active NPI

Akhil Kavuri

  • Psychiatry Physician
  • Park Ridge, IL
National Provider Identifier
1689314619
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
125.079653 Issued in IL
Practice address
1875 W Dempster St Ste 470
Park Ridge, IL 60068-1129
Phone
(847) 795-5865
Fax
(847) 723-5882
NPI assigned
Mar 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 125.079653 IL Primary

Addresses

Primary practice location

1875 W Dempster St Ste 470
Park Ridge, IL 60068-1129

Mailing address

1875 W Dempster St Ste 470
Park Ridge, IL 60068-1129
Phone (847) 795-5865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1701 E Woodfield Rd
Suite 1000
Schaumburg, IL 60173-5113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125.079653ILMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1689314619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 W DEMPSTER ST STE 470",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681129",
            "telephone_number": "847-795-5865",
            "fax_number": "847-723-5882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 W DEMPSTER ST STE 470",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681129",
            "telephone_number": "847-795-5865",
            "fax_number": "847-723-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVURI",
        "first_name": "AKHIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125.079653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.