Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Kalliath, DO

Individual provider Internal Medicine Physician · NPI 1134569395

Jacob Kalliath, DO is an Internal Medicine in Olympia Fields, Illinois. Graduated from Nova Southeastern College of Osteo Medicine in 2013, 13 years ago. Practices with Chelan County Public Hospital District No 2, a 19-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado, Illinois and Indiana.

Years since qualifying
13
Trained at
Nova Southeastern College of Osteo Medicine
Licensed in
CO, IL, IN
In the registry since
2013
Specialties on file
4
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

20201 Crawford Ave
Olympia Fields, IL 60461
Phone: (708) 679-2160
Fax: (708) 679-2161
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 — (574) 231-6134

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 12506386 (IL)
Internal Medicine Physician Taxonomy 207R00000X · Licence DR0057617 (CO)
Internal Medicine Physician Taxonomy 207R00000X · Licence 02005206A (IN)
Hospitalist Physician Taxonomy 208M00000X · Licence 036138730 (IL)

Record details

NPI number1134569395
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedJuly 2, 2013
Last updated in NPPESOctober 30, 2020
Certification dateOctober 30, 2020
Mailing address10624 S. Eastern Ave #263a, Henderson, NV 89052

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolNOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Graduated 2013 (13 years in practice)
Group practice Chelan County Public Hospital District No 2 — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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