Individual provider Active NPI

Bruce R Kaden, MD

  • Hematology & Oncology Physician
  • Niles, IL
National Provider Identifier
1720075179
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036056642 Issued in IL
Practice address
8915 W Golf Rd
Niles, IL 60714-5905
Phone
(847) 827-9060
Fax
(847) 827-7196
NPI assigned
Sep 30, 2005
Last updated
Oct 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036056642 IL Primary

Addresses

Primary practice location

8915 W Golf Rd
Niles, IL 60714-5905

Mailing address

25070 Network PL
Chicago, IL 60673-1250
Phone (847) 585-7000

Other identifiers 1

IdentifierTypeStateIssuer
036056642MedicaidIL

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036056642ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Cancer Specialists Hematology & Oncology Current Accepting new patients

Locations

25070 Network Pl
Chicago, IL 60673
Phone (847) 585-7000

8915 W Golf Rd
Niles, IL 60714
Phone (847) 692-9255

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1720075179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25070 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731250",
            "telephone_number": "847-585-7000",
            "fax_number": "847-240-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8915 W GOLF RD",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607145905",
            "telephone_number": "847-827-9060",
            "fax_number": "847-827-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADEN",
        "first_name": "BRUCE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036056642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036056642",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; 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.