Kevin P. Cullinane, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-072179 Issued in IL

Practice address

7411 Lake St
Suite 1120
River Forest, IL 60305-1876

Phone

(708) 488-1490

Fax

(708) 488-2394

NPI assigned

Jun 23, 2006

Last updated

May 19, 2022By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Loyola University Medical Center

  dba Foster G. McGaw Hospital

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD
• West Suburban Hospital Medical Center

  dba West Suburban Skilled Nursing Unit

  • Skilled Nursing Facility
  • Oak Park, IL
  • NPI 1538206974
  NPD (past)
• West Suburban Medical Center

  dba West Suburban Health Care Physicians SVCS

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1649499096
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1720014673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7411 LAKE ST",
            "address_2": "SUITE 1120",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051876",
            "telephone_number": "708-488-1490",
            "fax_number": "708-488-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7411 LAKE ST",
            "address_2": "SUITE 1120",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051876",
            "telephone_number": "708-488-1490",
            "fax_number": "708-488-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLINANE",
        "first_name": "KEVIN",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-072179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcullinane43679@direct.luhs.org",
            "affiliation": "Y",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Connect Hearing, Inc.
• Christine Lee Conte, LMT
• Pamela A Cools, D.D.S.
• Amy Johann Cortis, DC
• Courtney R Villari DDS (Ovation Dental)
• Karen Vanslyck Darley, DDS
• Lynda Kerstin De la Cotera, M.A.M.S.
• Amy Allyssa Deegan, LCSW
• Beatrice Defranco, LMT
• Dick J Derks, PHARMD

• Family Medicine Physician in River Forest, IL
• Providers in River Forest, 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 May 19, 2022; 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.