Individual provider Active NPI

Kellen Ann Gallagher, AU.D.

  • Audiologist
  • Chicago, IL
National Provider Identifier
1104777416
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147-000945 Issued in IL
Practice address
1611 W Harrison St Ste 530
Chicago, IL 60612-4861
Phone
(312) 942-5332
NPI assigned
Feb 4, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 23002884A IN
Audiologist 231H00000X 147-000945 IL Primary

Addresses

Primary practice location

1611 W Harrison St Ste 530
Chicago, IL 60612-4861

Mailing address

1611 W Harrison St Ste 530
Chicago, IL 60612-4861
Phone (312) 942-5332

Other practice location 1

9211 Southwood Dr
Munster, IN 46321-3021
Phone (773) 316-4301

Other names 1

  • Kellen Ann Rogan Gallagher Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260312003424 IL Practitioner - Qualified Audiologist 0446733950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1611 W Harrison St
Suite 530
Chicago, IL 60612-4861

1700 W Van Buren St
Suite 161
Chicago, IL 60612-3228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
147-000945ILMDAudiologist
23002884AINMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Feb 16, 2026 Accepting new patients

Locations

1611 W Harrison St
Ste 530
Chicago, IL 60612
Phone (312) 942-5332

Organizations & group practices 1

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": "1770163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1104777416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 530",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-942-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 530",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-942-5332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9211 Southwood Dr",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463213021",
            "country_code": "US",
            "telephone_number": "773-316-4301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "KELLEN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002884A",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147-000945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEN",
            "last_name": "ROGAN GALLAGHER",
            "middle_name": "ANN",
            "credential": "AU.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.