Individual provider Active NPI

Kenyatta Jamal Frazier, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1023303138
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
311112 Issued in LA
Practice address
2701 W 68TH St
Chicago, IL 60629-1813
Phone
(773) 884-9000
NPI assigned
Jun 16, 2011
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Q5652 TX
Emergency Medicine Physician 207P00000X 036.135877 IL
Emergency Medicine Physician 207P00000X 81776 WI
Emergency Medicine Physician 207P00000X 01096292A IN
Emergency Medicine Physician 207P00000X A158054 CA
Emergency Medicine Physician 207P00000X ME125282 FL
Emergency Medicine Physician 207P00000X MMD.38329MD SC
Emergency Medicine Physician 207P00000X 311112 LA Primary
Emergency Medicine Physician 207P00000X 125-059278 IL

Addresses

Primary practice location

2701 W 68TH St
Chicago, IL 60629-1813

Mailing address

5140 NE 18TH Ave
Fort Lauderdale, FL 33334-5727
Phone (843) 608-0928

Other practice location 1

800 Riverside Dr
Waupaca, WI 54981-1943
Phone (715) 258-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TX, SC, CA, LA, TN, WI, IN8 enrollments
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 8

Enrollment IDStateProvider typePAC IDDetails
I20140930002163 IL Practitioner - Emergency Medicine 7719107473 Reassigns benefits to 7 organizations
I20150929001191 TX Practitioner - Emergency Medicine 7719107473 Reassigns benefits to 4 organizations
I20151002001589 SC Practitioner - Emergency Medicine 7719107473 Reassigns benefits to 1 organization
I20190128002963 CA Practitioner - Emergency Medicine 7719107473 Reassigns benefits to 1 organization
I20200205000803 LA Practitioner - Emergency Medicine 7719107473 Reassigns benefits to 6 organizations
I20230823002642 TN Practitioner - Emergency Medicine 7719107473 Reassigns benefits to 7 organizations
I20230922001322 WI Practitioner - Emergency Medicine 7719107473 Reassigns benefits to 11 organizations
I20251119001835 IN Practitioner - Emergency Medicine 7719107473 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rockford Emergency Physicians, LLCGroup PAC ID 4385007640, 51 clinicians
Southern Wisconsin Emergency Associates SCGroup PAC ID 3274561055, 47 clinicians
Professional Emergency Physicians PCGroup PAC ID 2769384213, 79 clinicians

Practice addresses (Care Compare)

1401 E State St
Rockford, IL 61104-2315
Phone (779) 696-4400

1969 W Hart Rd
Beloit, WI 53511-2230
Phone (608) 364-5566

401 N Sawyer Rd
Kendallville, IN 46755-2568
Phone (260) 347-1100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A158054CAMDEmergency Medicine Physician
ME125282FLMDEmergency Medicine Physician
036.135877ILMDEmergency Medicine Physician
125-059278ILMDEmergency Medicine Physician
311112LAMDEmergency Medicine Physician
MMD.38329MDSCMDEmergency Medicine Physician
81776WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Lake Emergency Group, LLC Emergency Medicine CurrentSince May 29, 2020 Accepting new patients
Methodist University Emergency Physicians PLLC Emergency Medicine CurrentSince Feb 20, 2024 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Sep 30, 2025 Accepting new patients
Rockford Health Physicians CurrentSince Jul 1, 2016 Accepting new patients
Jefferson Davis Emergency Group LLC Emergency Medicine CurrentSince Sep 1, 2024 Accepting new patients
Professional Emergency Physicians PC Emergency Medicine CurrentSince Dec 15, 2025 Accepting new patients
Thedacare Medical Center - New London, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Emergency Services Midwest SC Emergency Medicine CurrentSince Apr 1, 2018 Accepting new patients
Path Lab Diagnostic Services, LLC Current Accepting new patients
Emergency Medicine Services of TX, PLLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
St Mary Medical Center CurrentSince Apr 1, 2019 Accepting new patients
Swea Fort SC Emergency Medicine CurrentSince Oct 6, 2024 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Sep 30, 2025 Accepting new patients
Belvidere Emergency Physicians, LLC Emergency Medicine CurrentSince Aug 15, 2023 Accepting new patients
Acs Primary Care Physicians Louisiana PC Emergency Medicine CurrentSince Dec 1, 2019 Accepting new patients
Montclair Emergency Medical Associates Emergency Medicine CurrentSince Feb 4, 2019 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Dec 1, 2025 Accepting new patients
Mount Sinai Community Foundation CurrentSince Jul 10, 2014 Accepting new patients
Sound Physicians Emergency Medicine of Louisiana Inc Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
River Oaks Emergency Group, LLC Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
Richland Memorial Hospital, Inc Current Accepting new patients
Sound Physicians Emergency Medicine of Texas PLLC Emergency Medicine CurrentSince Jan 1, 2020 Accepting new patients
Germantown Emergency Physicians, PLLC Emergency Medicine CurrentSince Feb 20, 2024 Accepting new patients
Thedacare Medical Center - New London, Inc. CurrentSince Sep 30, 2025 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Sep 30, 2025 Accepting new patients
Carr PLLC Emergency Medicine CurrentSince Aug 11, 2023 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Sep 30, 2025 Accepting new patients
Southern Wisconsin Emergency Associates SC Emergency Medicine CurrentSince May 12, 2025 Accepting new patients
Methodist South Emergency Physicians, PLLC Emergency Medicine CurrentSince Feb 20, 2024 Accepting new patients
Thedacare Medical Center - New London, Inc CurrentSince Sep 30, 2025 Accepting new patients
Rockford Emergency Physicians, LLC Emergency Medicine CurrentSince Aug 15, 2023 Accepting new patients
Nes Louisiana Inc Emergency Medicine CurrentSince Dec 17, 2019 Accepting new patients
Nes Louisiana Inc Emergency Medicine CurrentSince Dec 17, 2019 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Jul 1, 2016 Accepting new patients
Community Hospital of Lagrange County Inc CurrentSince Jan 1, 2026 Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Jun 28, 2022 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Sound Physicians Emergency Medicine of South Carolina LLC Emergency Medicine CurrentSince Nov 29, 2018 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Sep 30, 2025 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. Emergency Medicine CurrentSince Sep 30, 2025 Accepting new patients
Methodist North Emergency Physicians, PLLC Emergency Medicine CurrentSince Feb 20, 2024 Accepting new patients
Richard S Veiga MD SC Current Accepting new patients
Community Hospital of Lagrange County, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince Jul 1, 2016 Accepting new patients
St Mary Medical Center CurrentSince Apr 1, 2019 Accepting new patients
Mount Sinai Community Foundation CurrentSince Jul 10, 2014 Accepting new patients
T M Carr MD PC Emergency Medicine CurrentSince Aug 11, 2023 Accepting new patients

Locations (25 of 48)

5000 San Bernardino St
Montclair, CA 91763
Phone (909) 625-4111

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

1625 S State St
Belvidere, IL 61008
Phone (815) 544-1846

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

2701 W 68th St
Chicago, IL 60629
Phone (773) 471-8000

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

900 E Scott St
Olney, IL 62450
Phone (618) 345-1000

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

2200 Randallia Dr
Fort Wayne, IN 46805
Phone (260) 373-4000

401 N Sawyer Rd
Kendallville, IN 46755
Phone (260) 347-1100

207 N Townline Rd
Lagrange, IN 46761
Phone (260) 266-5300

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917

1634 Elton Rd
Jennings, LA 70546
Phone (337) 616-7000

524 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 430-4455

501 Keyser Ave
Natchitoches, LA 71457
Phone (318) 214-4200

2510 Bert Kouns Industrial Loop
Shreveport, LA 71118
Phone (318) 212-5000

8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

Organizations & group practices 48

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.

View all 48

Hospital & facility affiliations 6

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": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1023303138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 NE 18TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333345727",
            "telephone_number": "843-608-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 W 68TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606291813",
            "telephone_number": "773-884-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Waupaca",
            "state": "WI",
            "postal_code": "549811943",
            "country_code": "US",
            "telephone_number": "715-258-1000",
            "fax_number": "715-258-1153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "KENYATTA",
        "middle_name": "JAMAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-16",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q5652",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.135877",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "81776",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01096292A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A158054",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME125282",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "MMD.38329MD",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "311112",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125-059278",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.