Individual provider Active NPI

Jeremy Kao

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1982344719
Registry record updated Nov 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125.079955 Issued in IL
Practice address
820 S Wood St Ste 100
Chicago, IL 60612-4325
Phone
(312) 996-2933
NPI assigned
Mar 30, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2022

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 125.079955 IL Primary

Addresses

Primary practice location

820 S Wood St Ste 100
Chicago, IL 60612-4325

Mailing address

820 S Wood St Ste 100
Chicago, IL 60612-4325
Phone (312) 996-2933

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
I20220708002600 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1254711104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125.079955ILMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: jkao135918@uihealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669248000000",
    "number": "1982344719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S WOOD ST STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S WOOD ST STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAO",
        "first_name": "JEREMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-11-24",
        "certification_date": "2022-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.079955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.