Individual provider Active NPI

Nadya M Kohen, PA

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1063721264
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.003935 Issued in IL
Practice address
2400 N. Ashland Ave
Chicago, IL 60614
Phone
(773) 270-5600
Fax
(773) 360-7378
NPI assigned
Oct 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2672 WI
Physician Assistant 363A00000X 085.003935 IL Primary

Addresses

Primary practice location

2400 N. Ashland Ave
Chicago, IL 60614

Mailing address

2400 N. Ashland Ave
Chicago, IL 60614
Phone (773) 270-5600

Other names 1

  • Nadya Monique Modlin Former name

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
I20110407000786 IL Practitioner - Physician Assistant 2860687415 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Platinum Care, SCGroup PAC ID 7012210461, 19 clinicians

Practice addresses (Care Compare)

2400 N Ashland Ave
Chicago, IL 60614-0851
Phone (773) 270-5600

2400 N Ashland Ave
Suite 150
Chicago, IL 60614-2021

2418 N Ashland Ave
Chicago, IL 60614-2021
Phone (773) 900-8330

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.003935ILMDPhysician Assistant
2672WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Illinois, LLP CurrentSince Jan 1, 2017 Accepting new patients
Cepamerica Illinois LLP CurrentSince Jan 1, 2017 Accepting new patients
Mea-Aea Kenosha 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

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

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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1063721264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N. ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "telephone_number": "773-270-5600",
            "fax_number": "773-360-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N. ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "telephone_number": "773-270-5600",
            "fax_number": "773-360-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHEN",
        "first_name": "NADYA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2672",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.003935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NADYA",
            "last_name": "MODLIN",
            "middle_name": "MONIQUE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.