Kathleen Beavis
Individual provider Active NPI Clinical Pathology/Laboratory Medicine Physician · Chicago, IL
NPI 1689794075 · NPPES record last updated Oct 24, 2022
Key facts
- NPI
- 1689794075
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician 207ZP0105X
- License
- 036103230 (IL)
- Practice address
- 5841 S Maryland Ave
Chicago, IL 60637-1443 - Phone
- (888) 824-0200
- NPI assigned
- Mar 30, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Pathology
- Education
- Perelman School of Med at the University of Pennsylvania, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Chicago
Practice addresses (Care Compare)
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (888) 824-0200
Hospital & facility affiliations
- The University of Chicago Medical Center
- Silver Cross Hospital and Medical Centers
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110329000076 | IL | Practitioner - Pathology | 9032392063 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036103230 | IL | MD | Clinical Pathology/Laboratory Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Chicago | Current |
Accepting new patients |
Locations
150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061
350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500
120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | 036103230 | IL | Yes |
Addresses
Primary practice location
5841 S Maryland Ave
Chicago, IL 60637-1443
Mailing address
150 Harvester Dr
Suite 300
Burr Ridge, IL 60527-5919
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kbeavismd78760@uchospital.direct-ci.com | University of Chicago Physicians Group |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.