NPIMap

Individual provider Active NPI

Melissa Marie Kelly, DO

  • Hospitalist Physician
  • Bolingbrook, IL
National Provider Identifier
1104057843
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036-128764 Issued in IL
Practice address
1000 Remington Blvd
Suite 200 Attn: Aim
Bolingbrook, IL 60440-5114
Phone
(630) 312-7755
NPI assigned
Jul 29, 2009
Last updated
Mar 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.128764 IL
Hospitalist Physician 208M00000X 036-128764 IL Primary

Addresses

Primary practice location

1000 Remington Blvd
Suite 200 Attn: Aim
Bolingbrook, IL 60440-5114

Mailing address

1000 Remington Blvd
Suite 200 Attn: Aim
Bolingbrook, IL 60440-5114
Phone (630) 312-7755

Other names 1

  • Melissa Marie Dowden Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130123000498 IL Practitioner - Internal Medicine 4183877236 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advance Inpatient Medicine LLCGroup PAC ID 8022305697, 42 clinicians

Practice addresses (Care Compare)

500 Remington Blvd
Bolingbrook, IL 60440-4906
Phone (630) 312-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.128764ILMDInternal Medicine Physician
036-128764ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Inpatient Medicine LLC Hospitalist CurrentSince Oct 1, 2016 Accepting new patients
Suburban Pulmonary & Sleep Associates LTD CurrentSince Jun 3, 2018 Accepting new patients
Adventist Bolingbrook Hospital Past Accepting new patients

Locations

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

500 Remington Blvd
Bolingbrook, IL 60440
Phone (630) 312-5000

9500 Bryn Mawr Ave
Ste 300
Rosemont, IL 60018
Phone (847) 410-5706

1131 W Jefferson St
Shorewood, IL 60404

700 E Ogden Ave
Ste 202
Westmont, IL 60559
Phone (630) 528-3215

Organizations & group practices 3

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 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": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1104057843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 REMINGTON BLVD",
            "address_2": "SUITE 200 ATTN: AIM",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405114",
            "telephone_number": "630-312-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 REMINGTON BLVD",
            "address_2": "SUITE 200 ATTN: AIM",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405114",
            "telephone_number": "630-312-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-29",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.128764",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036-128764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "DOWDEN",
            "middle_name": "MARIE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.