Kelly Abate MD LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036093183 Issued in IL

Legal business name

KELLY ABATE MD LLC

Practice address

1200 S York St
Suite 3240
Elmhurst, IL 60126-5626

Phone

(630) 758-8688

Fax

(630) 758-8687

NPI assigned

Oct 24, 2016

Organization subpart

No

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

Authorized official

Name

Kelly Abate, MDNPI 1528141116

Title

Owner

Phone

(630) 758-8688

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Lynn Abate, M.D.

  • Dermatology Physician
  • New Lenox, IL
  • NPI 1528141116
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478908800000",
    "number": "1023569183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST",
            "address_2": "SUITE 3240",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265626",
            "telephone_number": "630-758-8688",
            "fax_number": "630-758-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST",
            "address_2": "SUITE 3240",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265626",
            "telephone_number": "630-758-8688",
            "fax_number": "630-758-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY ABATE MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-11-12",
        "status": "A",
        "authorized_official_last_name": "ABATE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-758-8688",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036093183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Maria Kecala
• Zenon Leo Kecala, M.D.
• Samuel B Keidan
• Keith L Guzaitis DDS Inc
• Annie O'Connell Kell, LCSW
• Brendan C Kelly, DPT
• Marguerite H Kelly, D.D.S.
• Nolan Kelly
• Kenilworth Optical Co Inc
• Naomi May Kern, CNP

• Dermatology Physician in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.