Kleven H Israelsen, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036083343 Issued in IL

Practice address

925 West St
Peru, IL 61354-2757

Phone

(815) 223-3300

Fax

(815) 223-3394

NPI assigned

May 17, 2006

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Integritas Emergency Physician Services, LLC

  • Emergency Medicine Physician
  • Carbondale, IL
  • NPI 1790128817
  Medicare reassignment NPD
• Lawrence County Memorial Hospital

  • Critical Access Hospital
  • Lawrenceville, IL
  • NPI 1396024162
  Medicare reassignment NPD
• Lawrence County Memorial Hospital

  • Critical Access Hospital
  • Lawrenceville, IL
  • NPI 1881643401
  Medicare reassignment NPD
• Statera Health Care, LLC

  • Emergency Medicine Physician
  • Harrisburg, IL
  • NPI 1043874449
  Medicare reassignment NPD
• Emergency Professionals of Indiana, P.C.

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1013951219
  Medicare reassignment NPD
• Lawrence County Memorial Hospital

  • Rural Health Clinic/Center
  • Lawrenceville, IL
  • NPI 1811183692
  NPD
• Associated Pathologists, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Nashville, TN
  • NPI 1003863580
  NPD
• CGH Medical Center

  • General Acute Care Hospital
  • Sterling, IL
  • NPI 1902854623
  NPD (past)
• Kennekuk Emergency Physicians LLC

  • Emergency Medicine Physician
  • Danville, IL
  • NPI 1659523777
  NPD (past)
• Mendota Community Hospital

  • Rural Health Clinic/Center
  • Granville, IL
  • NPI 1225877590
  NPD (past)
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  NPD (past)
• Rend Emergency Physicians

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1083803852
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247443200000",
    "number": "1740232560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GOLDENWOOD CT",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605026972",
            "telephone_number": "630-585-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 WEST ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542757",
            "telephone_number": "815-223-3300",
            "fax_number": "815-223-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAELSEN",
        "first_name": "KLEVEN",
        "middle_name": "H",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2009-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036083343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036083343-8",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Illinois Valley Ear, Nose & Throat Associates, Inc.
• Illinois Valley Endodontics LLC
• Illinois Valley Spine Institute LLC
• Curtis Roy Imel, DDS PC
• Independent for Life, Inc.
• J a K Enterprises Inc
• Alisha Jackson, FNP
• Joseph Barry Jackson, OD
• Elizabeth Sue Jennings-Porter, CNM
• Jacob Joachim, PHARMD

• Emergency Medicine Physician in Peru, IL
• Providers in Peru, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.