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NICOLAS KETTANEH M.D.
NPI 1063708196
Emergency Medicine in Oak Lawn, IL

Active since June 27, 2011PECOS Enrolled
4440 W 95TH ST, OAK LAWN, IL 60453(708) 684-5354(708) 684-1028 Get Directions Write a Review

NPPES record last updated: May 25, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Nicolas Kettaneh M.d. NPPES

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

NICOLAS KETTANEH M.D. (NPI 1063708196) is an individual emergency medicine provider in Oak Lawn, Illinois, licensed in Illinois (036.133560) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS and maintains a secondary practice location in Hinsdale.

NPPES Registry Identity

NPI1063708196
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameNICOLAS KETTANEHCredential: M.D.
Location Address4440 W 95TH STOak Lawn, IL 60453-2600
Mailing Address29373 Network PlChicago, IL 60673-1293 · (847) 390-5900
Phone(708) 684-5354
Fax(708) 684-1028
Sole ProprietorNo
Enumeration DateJune 27, 2011
Last NPPES UpdateMay 25, 2022
NPPES CertifiedMay 25, 2022
✔ NPI 1063708196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in IL · 036.133560
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
4440 W 95TH ST, Oak Lawn, IL 60453
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Secondary Practice Location 1

Location 1120 N Oak StHinsdale, IL 60521-3829 · Phone (630) 856-9000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicolas Kettaneh M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Nicolas Kettaneh reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Em Strategies,ltd.
18 mi
Emergency Medicine
1900 SILVER CROSS BLVD
New Lenox, IL 60451
  • Reassigned Medicare billing, Illinois enrollment
  • 66 clinicians in this Medicare group
NPI 1679791834 (815) 300-1100
Illinois Emergency Medicine Specialists, LLC
18 mi
Emergency Medical Services
500 REMINGTON BLVD
Bolingbrook, IL 60440
  • Reassigned Medicare billing, Illinois enrollment
  • 187 clinicians in this Medicare group
NPI 1003150962 (630) 312-5000

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

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
462 services444 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
138 services137 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
86 services85 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60453 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARK ADRIAN FAASSE MD
Urology
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-4557
DR. MANDY LUMA ENSHIWAT M.D.
Internal Medicine
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-8000
DR. KIM MARIE MIILLER MA, PSYD
Psychologist (Clinical)
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-7482
JENNIFER MARSIGLIO
Occupational Therapist (Physical Rehabilitation)
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-5425
TRACI LYNN TAGUE MA, CCC-SLP
Speech-Language Pathologist
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-1989
ELIZABETH A FOLLIARD OTR/L
Occupational Therapist
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-5369
MICHAEL CIRONE M.D.
Emergency Medicine
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (708) 684-5375
ANNA MANILLA
Speech-Language Pathologist
4440 W 95TH ST
OAK LAWN, IL 60453
Cook County (248) 701-7523

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 Nicolas Kettaneh's NPI number?

The NPI number for Nicolas Kettaneh is 1063708196. It was assigned to this individual provider in the NPPES registry on June 27, 2011.

Where is Nicolas Kettaneh located?

Nicolas Kettaneh practices at 4440 W 95th St, Oak Lawn, IL 60453. The listed phone number is (708) 684-5354.

What is Nicolas Kettaneh's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Nicolas Kettaneh enrolled in Medicare?

Yes. Nicolas Kettaneh is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Nicolas Kettaneh's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicolas Kettaneh reassigns Medicare benefits to 2 organizations: Em Strategies,ltd. (New Lenox, IL) and Illinois Emergency Medicine Specialists, LLC (Bolingbrook, IL). Each 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 Nicolas Kettaneh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicolas Kettaneh was last updated on May 25, 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.