Selena Chantae Kirkwood, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209013325 Issued in IL

Practice address

4440 W 95TH St
Oak Lawn, IL 60453-2600

Phone

(708) 684-5580

NPI assigned

Mar 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Selena Chantae Bradley Other name

Electronic endpoints 2

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Advocate Health and Hospitals Corporation

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment Care Compare group NPD
• Advocate Health & Hospitals Corporation

  • Medical Specialty Clinic/Center
  • Oak Lawn, IL
  • NPI 1912936014
  NPD
• Advocate Health and Hospitals Corporation

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1104286392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-5580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4101 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Lyons",
            "state": "IL",
            "postal_code": "605341028",
            "country_code": "US",
            "telephone_number": "800-323-8622",
            "fax_number": "224-225-0394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Erie Ct.",
            "address_2": "West Suburban Medical Center",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "60302",
            "country_code": "US",
            "telephone_number": "708-383-6200",
            "fax_number": "405-609-1318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRKWOOD",
        "first_name": "SELENA",
        "middle_name": "CHANTAE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-01",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skirkwood230739@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "4101 1st Ave",
            "city": "Lyons",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605341028",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4101 1st Ave",
            "city": "Lyons",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605341028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SELENA",
            "last_name": "BRADLEY",
            "middle_name": "CHANTAE",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Maria A. Kimovec, M.D.
• Asia King
• Thomas Joseph King Jr., D.D.S.
• Janice Nicole Kinney, FNP-BC
• Bridgit Kioko
• Serguei V Kishkurno, MD
• Dhadon Hannah Klein, MD
• Sarah Serviss Klein, D.O.
• Clifford Joseph Klimas, DO
• Suzanne Klimowski

• Family Nurse Practitioner in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.