Kathleen Marie Mansour, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-116906 Issued in IL

Practice address

1012 95TH St
Naperville, IL 60564-5041

Phone

(630) 548-1100

Fax

(630) 428-4211

NPI assigned

Jan 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kathleen.mansour.1@13306.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/13306/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Millennium Pediatrics LLC

  • Pediatrics Physician
  • Naperville, IL
  • NPI 1992870984
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1720137441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 95TH ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645041",
            "telephone_number": "630-548-1100",
            "fax_number": "630-428-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 95TH ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645041",
            "telephone_number": "630-548-1100",
            "fax_number": "630-428-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-116906",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A65218",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jyoti Mann, PHARMD.
• Ricca Lynnann Mann, PSY.D.
• Manor Care of Naperville Il LLC
• Callista Anastasia Manos, ATC
• Mary Marguerite Manseau, APN-CNP
• Jessica Mantovani
• Madhavi Manubolu, MD
• Christy L Manuel, PT
• Marina Ann Many
• Jamie Mapel, MS, CCC-SLP

• Pediatrics Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; 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.