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ANGEL HEALTH CARE SERVICES SC
NPI 1033352067
Internal Medicine in Chicago, IL

Active since April 07, 2009CLIA 14D1107350 · Waiver
7906 S CRANDON AVE, 2, CHICAGO, IL 60617(312) 730-4223 Get Directions Write a Review

NPPES record last updated: June 15, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Angel Health Care Services Sc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANGEL HEALTH CARE SERVICES SC (NPI 1033352067) is a healthcare organization registered as an internal medicine in Chicago, Illinois and active in the NPI registry since April 2009. The organization holds a CLIA Waiver certificate valid through November 2, 2027 and lists Kishore Khankari, President, as its authorized official.

NPPES Registry Identity

NPI1033352067
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameANGEL HEALTH CARE SERVICES SC
Location Address7906 S CRANDON AVE, 2Chicago, IL 60617-1146
Mailing Address7906 S Crandon Ave, 2Chicago, IL 60617-1146 · (312) 730-4223
Phone(312) 730-4223
Organization SubpartNo
Authorized OfficialKishore KhankariPresident · (312) 730-4223
Enumeration DateApril 7, 2009
Last NPPES UpdateJune 15, 2022
NPPES CertifiedJune 15, 2022
✔ NPI 1033352067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036104389
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
7906 S CRANDON AVE, Chicago, IL 60617
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Angel Health Care Services Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateIndianaEnrollment IDO20100205000146Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Angel Health Care Services Sc, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Kimberly Caceres
Nurse Practitioner
NPI 1376189415
8308 LOCKWOOD AVE
Burbank, IL 60459
(773) 603-0606
✔ PECOS✔ Accepts Medicare9.6 mi
Kishore Khankari, MD
Internal Medicine
NPI 1235210097
795 EL CAMINO REAL
Palo Alto, CA 94301
(650) 853-2977
✔ PECOS✔ Accepts Medicare1,857 mi
Shweta Khankari, M.D.
Internal Medicine
NPI 1992970800
795 EL CAMINO REAL
Palo Alto, CA 94301
(650) 853-2917
✔ PECOS1,857 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D1107350

Angel Health Care Services S C · Chicago, IL
Active · expires Nov 2, 2027
CLIA Number14D1107350
Laboratory TypePhysician Office
Certificate Effective DateNovember 3, 2025
Certificate Expiration DateNovember 2, 2027
Laboratory DirectorKishore N. Khankari
Laboratory Phone(888) 791-3999
Laboratory LocationAngel Health Care Services S C7906 S Crandon Ave, Ste 2, Chicago, IL 60617
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Angel Health Care Services Sc's NPI number?

The NPI number for Angel Health Care Services Sc is 1033352067. It was assigned to this organization in the NPPES registry on April 7, 2009.

Where is Angel Health Care Services Sc located?

Angel Health Care Services Sc is located at 7906 S Crandon Ave 2, Chicago, IL 60617. The listed phone number is (312) 730-4223.

What is Angel Health Care Services Sc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Angel Health Care Services Sc enrolled in Medicare?

Yes. Angel Health Care Services Sc is registered in the Medicare PECOS enrollment system.

When is Angel Health Care Services Sc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Indiana, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Angel Health Care Services Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Angel Health Care Services Sc, in Internal Medicine and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Angel Health Care Services Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1107350) is associated with this NPI, valid through November 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Angel Health Care Services Sc accept?

Health plans from Anthem Blue Cross and Blue Shield list Angel Health Care Services Sc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Angel Health Care Services Sc was last updated on June 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.