Individual provider Active NPI

Katherine Annette McKeough

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1013471150
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5159 S Ashland Ave
Chicago, IL 60609-4931
Phone
(773) 424-9216
NPI assigned
Jan 23, 2019
Last updated
Feb 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

5159 S Ashland Ave
Chicago, IL 60609-4931

Mailing address

5159 S Ashland Ave
Chicago, IL 60609-4931

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190624000102 IL Practitioner - Physician Assistant 3870827033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Rush Medical College of Rush University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1411 S Michigan Ave
Chicago, IL 60605-2810

1625 N Harlem Ave
Chicago, IL 60707-4303

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Dec 9, 2024 Accepting new patients
Access Community Health Network CurrentSince Jun 10, 2019 Accepting new patients
Access Community Health Network CurrentSince Jun 10, 2019 Accepting new patients
Rush University Medical Center CurrentSince Dec 9, 2024 Accepting new patients
Access Community Health Network Past Accepting new patients

Locations

1411 S Michigan Ave
Chicago, IL 60605
Phone (312) 454-2700

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

5159 S Ashland Ave
Chicago, IL 60609
Phone (773) 434-9126

75 Remittance Dr
Dept 1611
Chicago, IL 60675

Interoperability endpoints

  • Direct secure messaging: kmckeough11160@direct.achn.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1013471150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5159 S ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606094931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5159 S ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606094931",
            "telephone_number": "773-424-9216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEOUGH",
        "first_name": "KATHERINE",
        "middle_name": "ANNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.