Individual provider Active NPI

Nelson Kanter, MD

  • Pulmonary Disease Physician
  • Chicago, IL
National Provider Identifier
1750389490
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036053165 Issued in IL
Practice address
5140 N. California Ave
Suite 740-GMP
Chicago, IL 60625-7066
Phone
(773) 989-3957
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036053165 IL
Pulmonary Disease Physician 207RP1001X 036053165 IL Primary

Addresses

Primary practice location

5140 N. California Ave
Suite 740-GMP
Chicago, IL 60625-7066

Mailing address

5140 N. California Ave
Suite 740-GMP
Chicago, IL 60625-7066
Phone (773) 989-3957

Other practice location 1

5140 N. California Ave.
Suite 740-GMP
Chicago, IL 60625
Phone (773) 989-3957

Other identifiers 1

IdentifierTypeStateIssuer
036053165MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nkanter277035@direct.northshore.org
Direct Messaging Address nkanter277035@direct.northshore.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100416000243 IL Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 3971670472 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036053165ILMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Covenant Management Services, Inc. Internal Medicine Current Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Feb 6, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Feb 6, 2021 Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Sep 1, 2013 Accepting new patients
Swedish Covenant Management Services, Inc. CurrentSince Sep 1, 2013 Accepting new patients

Locations

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

5140 N California Ave
Chicago, IL 60625
Phone (773) 275-8811

9532 Eagle Way
Chicago, IL 60678

5140 N California Ave
Ste 740GMP
Chicago, IL 60625
Phone (773) 989-3957

2740 W Foster Ave
Ste 412
Chicago, IL 60625
Phone (773) 293-4362

2740 W Foster Ave
Ste LL7
Chicago, IL 60625

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

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

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

Interoperability endpoints

  • Direct secure messaging: nkanter277035@direct.northshore.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1750389490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 N. CALIFORNIA AVE",
            "address_2": "SUITE 740-GMP",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257066",
            "telephone_number": "773-989-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 N. CALIFORNIA AVE",
            "address_2": "SUITE 740-GMP",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257066",
            "telephone_number": "773-989-3957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5140 N. California Ave.",
            "address_2": "Suite 740-GMP",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60625",
            "country_code": "US",
            "telephone_number": "773-989-3957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANTER",
        "first_name": "NELSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2021-05-06",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036053165",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036053165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036053165",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkanter277035@direct.northshore.org",
            "affiliation": "N",
            "address_1": "4640 N Marine Dr",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606405719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkanter277035@direct.northshore.org",
            "affiliation": "N",
            "address_1": "5140 N. California Ave",
            "address_2": "Suite 740-GMP",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606257066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.