Individual provider Active NPI

Bala Kanagaraju, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1851315469
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
7914 S Ashland
Chicago, IL 60620
Phone
(773) 651-6800
Fax
(773) 651-1420
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

7914 S Ashland
Chicago, IL 60620

Mailing address

1807 Vollmer Rd
Flossmoor, IL 60422
Phone (773) 651-6800

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
I20100422000131 IL Practitioner - General PracticePractitioner - Pediatric Medicine 3870620909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Pediatric Medicine
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7914 S Ashland Ave
Chicago, IL 60620-4335
Phone (773) 651-6800

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bala Kanagaraju, M.D.S.C CurrentSince Jan 18, 2010 Accepting new patients

Locations

7914 S Ashland Ave
Chicago, IL 60620
Phone (773) 651-6800

Organizations & group practices 1

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 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851315469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 VOLLMER RD",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "60422",
            "telephone_number": "773-651-6800",
            "fax_number": "773-651-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7914 S ASHLAND",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60620",
            "telephone_number": "773-651-6800",
            "fax_number": "773-651-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAGARAJU",
        "first_name": "BALA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.