Kathleen Elizabeth Detwiler, PHD, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

XXXXXXXXXXXXXXXX Issued in IL

Practice address

2160 S 1St Ave
Luh North Entrance, Nuclear Medicine
Maywood, IL 60153-3328

Phone

(708) 202-7000

Fax

(708) 216-6890

NPI assigned

Apr 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kathleen Elizabeth Mandell Former name

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

Specialty

Nuclear MedicineAlso: Internal Medicine

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Current Care of Illinois PCGroup PAC ID 6002040276, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• American Current Care of Illinois PC

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1285071241

  IL

  Medicare reassignment Care Compare group NPD
• Ameriwound Physicians Il LLC

  • General Practice Physician
  • Skokie, IL
  • NPI 1104245893
  Medicare reassignment NPD
• Healogics Specialty Physicians of Illinois, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Alton, IL
  • NPI 1215355110

  Internal Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1932465259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 E QUINCY ST",
            "city": "RIVERSIDE",
            "state": "IL",
            "postal_code": "605462178",
            "telephone_number": "630-202-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "LUH NORTH ENTRANCE, NUCLEAR MEDICINE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-202-7000",
            "fax_number": "708-216-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWILER",
        "first_name": "KATHLEEN",
        "middle_name": "ELIZABETH",
        "credential": "PHD, MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "IL",
            "license": "125061472",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "XXXXXXXXXXXXXXXX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "MANDELL",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Naomi Amish Desai
• Nirmal Desai, MD
• Shilpa Vijay Desai, D.O.
• Caroline Desler, MD
• Joyce Despe, APN
• Manubolu Devanand, MD
• Kartik Devgan
• Grace Devitt
• Heidi Deyro
• Nina Dharmarajah, MD

• Internal Medicine Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.