Active NPI
Melissa Mae Kilianek
- Urology Physician
- Olympia Fields, IL
National Provider Identifier
1972205748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 125084853
- Practice address
- 20201 Crawford Ave
Olympia Fields, IL 60461-1010 - Phone
- (708) 855-7021
- NPI assigned
- Mar 17, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 125084853 | IL | Primary |
Addresses
Primary practice location
20201 Crawford Ave
Olympia Fields, IL 60461-1010
Mailing address
555 31St St
Downers Grove, IL 60515-1235
Phone (800) 458-6253
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240716000789 | IL | Order and Referring Only - Urology | 0446795314 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125084853 | IL | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721865600000",
"number": "1972205748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 31ST ST",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605151235",
"telephone_number": "800-458-6253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20201 CRAWFORD AVE",
"city": "OLYMPIA FIELDS",
"state": "IL",
"postal_code": "604611010",
"telephone_number": "708-855-7021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILIANEK",
"first_name": "MELISSA",
"middle_name": "MAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-17",
"last_updated": "2024-07-25",
"certification_date": "2024-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IL",
"license": "125084853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia Fields, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.