Active NPI
Stuart Kiken, MD
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1790868008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036-059941
- Practice address
- 2720 W 15TH St
4TH Floor
Chicago, IL 60608-1610 - Phone
- (773) 257-6730
- Fax
- (773) 257-4775
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-059941 | IL | |
| Internal Medicine Physician | 207R00000X | 036-059941 | IL | Primary |
Addresses
Primary practice location
2720 W 15TH St
4TH Floor
Chicago, IL 60608-1610
Mailing address
2720 W 15TH St
4TH Floor
Chicago, IL 60608-1610
Phone (773) 257-6730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-059941 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Community Health Network | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Internal Medicine | Current | Accepting new patients |
| Access Community Health Network | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Current | Accepting new patients | |
| Access Community Health Network | Current | Accepting new patients |
Locations
600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000
26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900
2720 W 15th St
Fl 4
Chicago, IL 60608
Phone (773) 257-6730
Organizations & group practices 6
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.
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1538247762
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1699701383
-
- Federally Qualified Health Center (FQHC)
- Des Plaines, IL
- NPI 1982783692
-
- Rehabilitation Hospital
- Chicago, IL
- NPI 1376715896
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1578972188
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1982657854
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336867200000",
"number": "1790868008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2720 W 15TH ST",
"address_2": "4TH FLOOR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606081610",
"telephone_number": "773-257-6730",
"fax_number": "773-257-4775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2720 W 15TH ST",
"address_2": "4TH FLOOR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606081610",
"telephone_number": "773-257-6730",
"fax_number": "773-257-4775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIKEN",
"first_name": "STUART",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2012-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036-059941",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036-059941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2012; 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.