Individual provider Active NPI

Nicholas Kiran Singh Grewal, MD

  • Cardiovascular Disease Physician
  • Chicago, IL
National Provider Identifier
1962089110
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036166905 Issued in IL
Practice address
1725 W Harrison St Ste 1159
Chicago, IL 60612-3883
Phone
(888) 352-7847
NPI assigned
Mar 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.078034 IL
Cardiovascular Disease Physician 207RC0000X 036166905 IL Primary

Addresses

Primary practice location

1725 W Harrison St Ste 1159
Chicago, IL 60612-3883

Mailing address

1725 W Harrison St Ste 1159
Chicago, IL 60612-3883
Phone (888) 352-7847

Other practice location 1

251 E Huron St
Chicago, IL 60611-3055
Phone (312) 926-2000

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
I20210618000048 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3577963123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036166905ILMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1962089110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 1159",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123883",
            "telephone_number": "888-352-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 1159",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123883",
            "telephone_number": "888-352-7847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 E Huron St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606113055",
            "country_code": "US",
            "telephone_number": "312-926-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "NICHOLAS",
        "middle_name": "KIRAN SINGH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2024-04-24",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.078034",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036166905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.