Individual provider Active NPI

Katherine Tynus, MD

  • Internal Medicine Physician
  • Oak Lawn, IL
National Provider Identifier
1932133766
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-091710 Issued in IL
Practice address
6101 W 95TH St
Oak Lawn, IL 60453-2735
Phone
(708) 783-6500
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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 036-091710 IL Primary

Addresses

Primary practice location

6101 W 95TH St
Oak Lawn, IL 60453-2735

Mailing address

6101 W 95TH St
Oak Lawn, IL 60453-2735

Other identifiers 1

IdentifierTypeStateIssuer
036091710MedicaidIL

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
I20080201000602 IL Practitioner - Internal Medicine 3577645209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alivio Medical Center, Inc.Group PAC ID 5698840924, 23 clinicians

Practice addresses (Care Compare)

966 W 21St St
Chicago, IL 60608-4511
Phone (773) 254-1400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-091710ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alivio Medical Center, Inc. CurrentSince Jul 1, 2023 Accepting new patients
PMR Illinois Holding, LLC CurrentSince Jan 1, 2022 Accepting new patients
Alivio Medical Center, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Alivio Medical Center, Inc. Current Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

966 W 21st St
Chicago, IL 60608
Phone (773) 254-1400

2355 S Western Ave
Chicago, IL 60608
Phone (773) 254-1400

2734 W 87th St
Chicago, IL 60652
Phone (773) 918-4700

6101 W 95th St
Oak Lawn, IL 60453
Phone (708) 261-0831

Organizations & group practices 4

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 5

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1932133766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532735",
            "telephone_number": "708-783-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNUS",
        "first_name": "KATHERINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-091710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091710",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.