NPIMap

Individual provider Active NPI

John Nicholas Kiriklakis, M.D.

  • Internal Medicine Physician
  • Vernon Hills, IL
National Provider Identifier
1730189713
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-100938 Issued in IL
Practice address
225 N Milwaukee Ave
Vernon Hills, IL 60061-4304
Phone
(847) 941-7600
Fax
(847) 941-7698
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-100938 IL Primary

Addresses

Primary practice location

225 N Milwaukee Ave
Vernon Hills, IL 60061-4304

Mailing address

2650 Ridge Ave
Evanston, IL 60201-1718

Other identifiers 1

IdentifierTypeStateIssuer
036100938MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkiriklakis225810@direct.northshore.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060301000728 IL Practitioner - Internal Medicine 6002822988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

225 N Milwaukee Ave
Vernon Hills, IL 60061-4304
Phone (847) 941-7600

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-100938ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 15, 2010 Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Dec 15, 2010 Accepting new patients
West Suburban Medical Center Internal Medicine Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

225 N Milwaukee Ave
Vernon Hills, IL 60061
Phone (847) 941-7600

Interoperability endpoints

  • Direct secure messaging: jkiriklakis225810@direct.northshore.org

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1730189713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N MILWAUKEE AVE",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600614304",
            "telephone_number": "847-941-7600",
            "fax_number": "847-941-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRIKLAKIS",
        "first_name": "JOHN",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-100938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100938",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkiriklakis225810@direct.northshore.org",
            "affiliation": "N",
            "address_1": "225 N Milwaukee Ave",
            "city": "Vernon Hills",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600614304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vernon Hills, IL

Sources for this page

Verify at the official NPI Registry.