NPIMap

Individual provider Active NPI

Kelley Meisner

  • Physician Assistant
  • Algonquin, IL
National Provider Identifier
1184295032
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.008649 Issued in IL
Practice address
1340 Ryan Pkwy
Algonquin, IL 60102-4527
Phone
(815) 276-0150
Fax
(877) 461-6742
NPI assigned
Jul 1, 2021
Last updated
Mar 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.008649 IL Primary

Addresses

Primary practice location

1340 Ryan Pkwy
Algonquin, IL 60102-4527

Mailing address

1340 Ryan Pkwy
Algonquin, IL 60102-4527
Phone (815) 276-0150

Other practice location 1

2425 Royal Blvd
Elgin, IL 60123-2507
Phone (847) 289-8555

Other practice location 2

860 Summit St Ste 123
Elgin, IL 60120-4350
Phone (847) 741-0026

Other names 1

  • Kelley Zych 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
I20231107003577 IL Practitioner - Physician Assistant 0345604153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Midwestern University, Chicago College of Osteopathic Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Favia Primary Care SCGroup PAC ID 4284983974, 4 clinicians

Practice addresses (Care Compare)

1340 Ryan Pkwy
Algonquin, IL 60102-4527
Phone (815) 276-0150

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Pulmonary and Sleep Medicine SC CurrentSince Oct 1, 2023 Accepting new patients
V Susarla MDSC PastSince Feb 1, 2006 Accepting new patients

Locations

1340 Ryan Pkwy
Algonquin, IL 60102
Phone (815) 276-0150

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CIHEBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/ECGEBD/Endpoint/ECGEBD
  • Direct secure messaging: kzych323300@direct.myadvocateaurora.org

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": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1184295032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 RYAN PKWY",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601024527",
            "telephone_number": "815-276-0150",
            "fax_number": "877-461-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 RYAN PKWY",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601024527",
            "telephone_number": "815-276-0150",
            "fax_number": "877-461-6742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2425 Royal Blvd",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601232507",
            "country_code": "US",
            "telephone_number": "847-289-8555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "860 Summit St Ste 123",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601204350",
            "country_code": "US",
            "telephone_number": "847-741-0026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEISNER",
        "first_name": "KELLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "ZYCH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Algonquin, IL

Sources for this page

Verify at the official NPI Registry.