Provider Demographics
NPI:1528028180
Name:KANE, JAMES M JR
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:KANE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4885 HOFFMAN BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-3726
Mailing Address - Country:US
Mailing Address - Phone:847-255-9697
Mailing Address - Fax:847-255-3206
Practice Address - Street 1:4885 HOFFMAN BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60192-3726
Practice Address - Country:US
Practice Address - Phone:847-255-9697
Practice Address - Fax:847-255-3206
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036071947174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036071947Medicaid
IL036071947Medicaid
IL925300Medicare ID - Type Unspecified