Active NPI
Kathryn Ilissa Ross, PA-C
- Physician Assistant
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 259 E Erie St Ste 1600
Chicago, IL 60611-3111 - Phone
- (312) 695-5620
- Fax
- (312) 695-2310
- NPI assigned
- Jul 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN004758 | PA | |
| Medical Physician Assistant | 363AM0700X | 085006742 | IL | |
| Physician Assistant | 363A00000X | IL | Primary |
Addresses
Primary practice location
259 E Erie St Ste 1600
Chicago, IL 60611-3111
Mailing address
259 E Erie St Ste 1600
Chicago, IL 60611-3111
Phone (312) 695-5620
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1512 Artaius Pkwy
Suite 102
Libertyville, IL 60048-5231
Phone (847) 847-2230
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN004758 | PA | MD | Registered Dietitian |
| 085006742 | IL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rush University Medical Center | Current | Accepting new patients | |
| Rockford Psychiatric Medical Services, S.C. | Current | Accepting new patients | |
| Rush University Medical Group | Current | Accepting new patients | |
| Central Dupage Physician Group | Past | Accepting new patients | |
| Miinehealth, Inc. | Past | Accepting new patients |
Locations
1725 W Harrison St
Ste 818
Chicago, IL 60612
Phone (312) 942-4444
75 Remittance Dr
Dept 1611
Chicago, IL 60675
1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875
32 E 1st St
Hinsdale, IL 60521
1512 Artaius Pkwy
Ste 102
Libertyville, IL 60048
Phone (847) 847-2230
5851 W 95th St
Oak Lawn, IL 60453
Phone (708) 574-6143
1639 N Alpine Rd
Ste 260
Rockford, IL 61107
Phone (815) 395-1500
Organizations & group practices 6
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.
-
- Psychiatry Physician
- Rockford, IL
- NPI 1821391442
-
dba Rush University Internists
- Internal Medicine Physician
- Chicago, IL
- NPI 1093819542
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chicago, IL
- NPI 1063803856
-
dba Radiology Services
- Diagnostic Radiology Physician
- Chicago, IL
- NPI 1184269425
-
dba Northwestern Medicine Regional Medical Group
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
-
- Internal Medicine Physician
- Naperville, IL
- NPI 1538862230
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689033600000",
"number": "1124434014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 E ERIE ST STE 1600",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606113111",
"telephone_number": "312-695-5620",
"fax_number": "312-695-2310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 E ERIE ST STE 1600",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606113111",
"telephone_number": "312-695-5620",
"fax_number": "312-695-2310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "KATHRYN",
"middle_name": "ILISSA",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-11",
"last_updated": "2023-07-11",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN004758",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IL",
"license": "085006742",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Jul 11, 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.