Individual provider Active NPI

Kenneth Lamont Fox, MD

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1972513984
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Practice address
1701 W Superior St
Chicago, IL 60622-5646
Phone
(312) 666-3494
Fax
(312) 666-5867
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X IL Primary

Addresses

Primary practice location

1701 W Superior St
Chicago, IL 60622-5646

Mailing address

651 S Wells St
Unit #701
Chicago, IL 60607-4508
Phone (708) 539-6863

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
I20040622000056 IL Practitioner - Pediatric Medicine 7214912542 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036110808ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center, Inc CurrentSince Jun 26, 2023 Accepting new patients
Erie Family Health Center Inc CurrentSince Jun 26, 2023 Accepting new patients
Endeavor Health Medical Group Past Accepting new patients
Pediatric Faculty Foundation, Inc Past Accepting new patients

Locations

1701 W Superior St
Chicago, IL 60622
Phone (312) 432-7392

1701 W Superior St
Fl 2
Chicago, IL 60622
Phone (323) 361-2122

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

251 E Huron St
Chicago, IL 60611

1504 S Albany Ave
Chicago, IL 60623

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Interoperability endpoints

  • Direct secure messaging: kfox643738@direct.ochin.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972513984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 S WELLS ST",
            "address_2": "UNIT #701",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074508",
            "telephone_number": "708-539-6863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W SUPERIOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225646",
            "telephone_number": "312-666-3494",
            "fax_number": "312-666-5867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "KENNETH",
        "middle_name": "LAMONT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.