Individual provider Active NPI

Katherine Granberry, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1881612471
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-063715 Issued in IL
Practice address
9831 S Western Ave
Chicago, IL 60643-1791
Phone
(773) 445-3500
NPI assigned
Jul 18, 2006
Last updated
Jun 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-063715 IL Primary

Addresses

Primary practice location

9831 S Western Ave
Chicago, IL 60643-1791

Mailing address

29373 Network PL
Chicago, IL 60673-1225
Phone (847) 390-5900

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kgranberry205338@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20100107000532 IL Practitioner - Internal Medicine 4587705900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9831 S Western
Chicago, IL 60643
Phone (773) 881-5232

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-063715ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince May 18, 2015 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince May 18, 2015 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

1945 W Wilson Ave
Fl 4
Chicago, IL 60640
Phone (773) 736-6220

2545 S Ml King Dr
Chicago, IL 60616
Phone (312) 842-7117

29373 Network Pl
Chicago, IL 60673

9831 S Western Ave
Chicago, IL 60643
Phone (773) 445-3500

Interoperability endpoints

  • Direct secure messaging: kgranberry205338@direct.myadvocateaurora.org

Organizations & group practices 2

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1881612471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731225",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9831 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431791",
            "telephone_number": "773-445-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANBERRY",
        "first_name": "KATHERINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-063715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgranberry205338@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9831 S Western Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606431791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "9831 S Western Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606431791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.