Kevin M Smith, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-093367 Issued in IL

Practice address

1333 Burr Ridge Pkwy Ste 200
Burr Ridge, IL 60527-0833

Phone

(630) 756-5270

Fax

(574) 538-4859

NPI assigned

Aug 29, 2006

Last updated

Jun 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, IN2 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

Specialty

Family Practice

Education

University of Iowa, RJ & L Carver College of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vein Clinics of Chicago LLCGroup PAC ID 1153572383, 9 clinicians

Congress Vein Clinic LLCGroup PAC ID 6709148414, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 28)

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.

• Congress Vein Clinic LLC

  • Trauma Surgery Physician
  • Chicago, IL
  • NPI 1467986901
  Medicare reassignment Care Compare group NPD
• Vein Clinics of Chicago LLC

  • Vascular Surgery Physician
  • Chicago, IL
  • NPI 1386904621
  Medicare reassignment Care Compare group NPD
• Ameriwound Physicians Il LLC

  • General Practice Physician
  • Skokie, IL
  • NPI 1104245893
  Medicare reassignment NPD
• Congress Vascular Center LLC

  • Vascular Surgery Physician
  • Chicago, IL
  • NPI 1396267324
  Medicare reassignment NPD
• Illinois Phlebology Associates SC

  • Surgery Physician
  • Orland Park, IL
  • NPI 1154378040
  Medicare reassignment NPD
• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment NPD
• Vpa PC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Oakbrook Terrace, IL
  • NPI 1174925663
  Medicare reassignment NPD
• PMR Illinois Holding, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1770038671

  IL

  Medicare reassignment NPD
• Ameriwound Physicians in LLC

  • Specialist
  • Whiting, IN
  • NPI 1801312863
  NPD
• Vpa PC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362
  NPD
• Fastrac Medical, P.C.

  • Emergency Medicine Physician
  • Joliet, IL
  • NPI 1659517597
  NPD (past)
• Morris Hospital

  dba Morris Hospital & Healthcare Centers

  • General Practice Physician
  • Channahon, IL
  • NPI 1275648511

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1710096557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 BURR RIDGE PKWY STE 200",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270833",
            "telephone_number": "630-756-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 BURR RIDGE PKWY STE 200",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270833",
            "telephone_number": "630-756-5270",
            "fax_number": "574-538-4859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Gore Rd",
            "address_2": "Ste. H",
            "address_purpose": "LOCATION",
            "city": "Morris",
            "state": "IL",
            "postal_code": "604509466",
            "country_code": "US",
            "telephone_number": "815-364-8919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEVIN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-093367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093367",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Skorodin, PHARMD
• John Peter Slauson, PTA
• Brittany Smith
• Christopher R Smith, DDS
• Elizabeth Ann Smith, LPC, ATR
• Sheri Lynn Smith
• SMS Medical Inc
• SMSM Seniors Service LLC
• Sodipe and Associates, Inc (Olukayode a. Sodipe)
• Tatjana Solar

• Family Medicine Physician in Burr Ridge, IL
• Providers in Burr Ridge, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.