Individual provider Active NPI

Kristin Peterson, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1053675140
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036136507 Issued in IL
Practice address
7435 W Talcott Ave
Resurrection Em Residency
Chicago, IL 60631-3707
Phone
(773) 792-7921
NPI assigned
Jul 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036136507 IL Primary

Addresses

Primary practice location

7435 W Talcott Ave
Resurrection Em Residency
Chicago, IL 60631-3707

Mailing address

7435 W Talcott Ave
Resurrection Em Residency
Chicago, IL 60631-3707

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
I20150212001352 IL Practitioner - Emergency Medicine 8022333129 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

5140 N California
Suite G600
Chicago, IL 60625-3645
Phone (773) 989-3803

5140 N California Ave
Chicago, IL 60625-3645

Hospital & facility affiliations

  • Swedish Hospital Hospital, Chicago, IL, CCN 140114

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036136507ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Emergency Medicine Current Accepting new patients
Endeavor Health Medical Group CurrentSince Jan 15, 2024 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jan 1, 2017 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients
Cep America - Illinois, LLP Emergency Medicine CurrentSince Jan 1, 2017 Accepting new patients
Community First Healthcare of Illinois, Inc. Emergency Medicine CurrentSince Mar 31, 2024 Accepting new patients
Community First Healthcare of Illinois, Inc. CurrentSince Mar 31, 2024 Accepting new patients
Wyse Eyecare SC Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

2800 N Sheridan Rd
Ste 60
Chicago, IL 60657
Phone (773) 525-8846

9532 Eagle Way
Chicago, IL 60678

7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

355 Ridge Ave
Evanston, IL 60202
Phone (847) 316-2329

Organizations & group practices 8

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 1

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": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1053675140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "address_2": "RESURRECTION EM RESIDENCY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "address_2": "RESURRECTION EM RESIDENCY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313707",
            "telephone_number": "773-792-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036136507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.