Individual provider Active NPI

Janice L. Keane, A.N.P.

  • Nurse Practitioner
  • Calumet City, IL
National Provider Identifier
1871502955
Registry record updated Jul 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209001890 Issued in IL
Practice address
19 River Oaks Dr
Calumet City, IL 60409-5802
Phone
(708) 862-1290
NPI assigned
Aug 6, 2006
Last updated
Jul 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209001890 IL Primary

Addresses

Primary practice location

19 River Oaks Dr
Calumet City, IL 60409-5802

Mailing address

19 River Oaks Dr
Calumet City, IL 60409-5802
Phone (708) 862-1290

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080411000566 IL Practitioner - Nurse Practitioner 5092892265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bielinski Dermatology Group LLCGroup PAC ID 6406868769, 10 clinicians

Practice addresses (Care Compare)

16105 S la Grange Rd
Orland Park, IL 60467-5503
Phone (708) 636-3767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209001890ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bielinski Dermatology Group, LLC CurrentSince Feb 29, 2016 Accepting new patients

Locations

3900 W 95th St
Ste 12
Evergreen Pk, IL 60805
Phone (708) 423-7550

16105 S La Grange Rd
Orland Park, IL 60467
Phone (708) 636-3767

Interoperability endpoints

  • Direct secure messaging: jakeane@directaddress.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1871502955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 RIVER OAKS DR",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095802",
            "telephone_number": "708-862-1290",
            "fax_number": "708-862-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 RIVER OAKS DR",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095802",
            "telephone_number": "708-862-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEANE",
        "first_name": "JANICE",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "A.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-06",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209001890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calumet City, IL

Sources for this page

Verify at the official NPI Registry.