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JACQUELINE L KANNAN M.D.
NPI 1588058606
Internal Medicine - Rheumatology in Mchenry, IL

Active since March 26, 2015PECOS Enrolled
70.99/100
CMS Quality Rating
4119 W SHAMROCK LN, MCHENRY, IL 60050(815) 398-9491(815) 381-7498 Get Directions Write a Review

NPPES record last updated: December 21, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 21, 2021, Jul 17, 2020, Aug 7, 2018 (3 updates tracked since 2018).

About Jacqueline L Kannan M.d. NPPES

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

JACQUELINE L KANNAN M.D. (NPI 1588058606) is an individual rheumatology provider in Mchenry, Illinois, licensed in Illinois (036-152551) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588058606
Entity TypeIndividualFemale
Primary Taxonomy207RR0500X
Provider Legal NameJACQUELINE L KANNANCredential: M.D.
Location Address4119 W SHAMROCK LNMchenry, IL 60050-8268
Mailing AddressBox 78534Milwaukee, WI 53278-8534 · (815) 398-9491 · Fax (815) 381-7498
Phone(815) 398-9491
Fax(815) 381-7498
Sole ProprietorYes
Enumeration DateMarch 26, 2015
Last NPPES UpdateDecember 21, 20213 updates tracked since enumeration
NPPES CertifiedDecember 21, 2021
✔ NPI 1588058606 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License✔ Licensed in IL · 036-152551
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
4119 W SHAMROCK LN, Mchenry, IL 60050
Open in Google Maps ↗

Other Names 1

Former Name (1)Jacqueline L Vaidya

Other Identifiers 1

Medicaid125073073IL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline L Kannan 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60050 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
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

70.99/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality61
Promoting Interoperability74
Improvement Activities40
Cost63.98

Other Providers at the Same Location NPPES 10

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

DR. GEORGE LANE STANKEVYCH M.D.
Obstetrics & Gynecology
4119 W SHAMROCK LN, SUITE 200
MCHENRY, IL 60050
McHenry County (815) 344-1611
MRS. GRETCHEN ANN DABROWSKI CNM
Advanced Practice Midwife
4119 W SHAMROCK LN, SUITE 200
MCHENRY, IL 60050
McHenry County (815) 344-1611
UMBER AHMAD DO
Internal Medicine (Rheumatology)
4119 W SHAMROCK LN
MCHENRY, IL 60050
McHenry County (815) 398-9491
LELAND T. GOUGH DPT
Physical Therapist
4119 W SHAMROCK LN
MCHENRY, IL 60050
McHenry County (815) 398-9491
DR. SCOTT J SPENGEL DC
Chiropractor
4119 W SHAMROCK LN
MCHENRY, IL 60050
McHenry County (815) 398-9491
ORTHOMIDWEST, PLLC
Durable Medical Equipment & Medical Supplies
4119 W SHAMROCK LN
MCHENRY, IL 60050
McHenry County (815) 398-9491
GEORGE L STANKEVYCH MD PC
Obstetrics & Gynecology
4119 W SHAMROCK LN, SUITE 200
MCHENRY, IL 60050
McHenry County (815) 344-1611
J & K PEDIATRICS AND ASSOCIATES, LLC
Pediatrics
4119 W SHAMROCK LN, SUITE 201
MCHENRY, IL 60050
McHenry County (815) 759-9407

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 Jacqueline Kannan's NPI number?

The NPI number for Jacqueline Kannan is 1588058606. It was assigned to this individual provider in the NPPES registry on March 26, 2015. The provider is also known as Jacqueline L Vaidya.

Where is Jacqueline Kannan located?

Jacqueline Kannan practices at 4119 W Shamrock Ln, Mchenry, IL 60050. The listed phone number is (815) 398-9491.

What is Jacqueline Kannan's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Jacqueline Kannan enrolled in Medicare?

Yes. Jacqueline Kannan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacqueline Kannan was last updated on December 21, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.