Individual provider Active NPI

Keri Leah Fair, M.D., PH.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1003073735
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036119844 Issued in IL
Practice address
4600 N Ravenswood Ave
2ND Floor
Chicago, IL 60640-4510
Phone
(773) 561-7500
Fax
(773) 561-7612
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036119844 IL Primary

Addresses

Primary practice location

4600 N Ravenswood Ave
2ND Floor
Chicago, IL 60640-4510

Mailing address

4600 N Ravenswood Ave
2ND Floor
Chicago, IL 60640-4510
Phone (773) 561-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080929000625 IL Practitioner - Family Practice 0446327738 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

610 S Maple Ave
Suite 5500
Oak Park, IL 60304-2808
Phone (708) 660-5777

Hospital & facility affiliations

  • Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063
  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center CurrentSince Apr 1, 2025 Accepting new patients
Rush Oak Park Physicians Group Family Medicine Family Medicine CurrentSince Jan 1, 2012 Accepting new patients
Rush Oak Park ER Physicians Group CurrentSince Mar 23, 2020 Accepting new patients
Rush University Medical Group Family Medicine CurrentSince Apr 1, 2025 Accepting new patients
Rush Oak Park Physicians Group Adult Medicine Past Accepting new patients
Rush Presbyterian St. Lukes Medical Center Family Medicine Past Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

75 Remittance Dr
Dept 1620
Chicago, IL 60675

610 S Maple Ave
Ste 3900
Oak Park, IL 60304
Phone (708) 524-1674

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

610 S Maple Ave
Ste 2900
Oak Park, IL 60304
Phone (708) 383-0088

Networks

  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • IL HMO C-SNP
  • IL PPO Downstate

Interoperability endpoints

  • Direct secure messaging: kfair37625@direct.rush.rush-health.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1003073735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 N RAVENSWOOD AVE",
            "address_2": "2ND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404510",
            "telephone_number": "773-561-7500",
            "fax_number": "773-561-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 N RAVENSWOOD AVE",
            "address_2": "2ND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404510",
            "telephone_number": "773-561-7500",
            "fax_number": "773-561-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "KERI",
        "middle_name": "LEAH",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036119844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.