Individual provider Active NPI

Laura Ann Kavlie, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1184968646
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085004512 Issued in IL
Practice address
2701 W 68TH St
Chicago, IL 60629-1813
Phone
(773) 884-9000
NPI assigned
Nov 21, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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 085004512 IL Primary

Addresses

Primary practice location

2701 W 68TH St
Chicago, IL 60629-1813

Mailing address

1115 S Oak Park Ave Apt 2
Oak Park, IL 60304-2616
Phone (616) 558-0693

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150120000961 IL Practitioner - Physician Assistant 3476877531 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

1690 W Lake St
Addison, IL 60101-1833
Phone (630) 283-6633

335 E Army Trail Rd
Glendale Heights, IL 60139-1755
Phone (630) 735-1400

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

800 W Plainfield Rd
Countryside, IL 60525-3745
Phone (708) 298-0543

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.45
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085004512ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Emergency Physicians, LLC CurrentSince Feb 1, 2022 Accepting new patients
Cepamerica Illinois LLP CurrentSince Nov 1, 2017 Accepting new patients
Cepamerica Illinois LLP CurrentSince Nov 1, 2017 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

600 S Randall Rd
Algonquin, IL 60102
Phone (224) 783-4300

2000 Ogden Ave
Aurora, IL 60504
Phone (630) 466-8200

2701 W 68th St
Chicago, IL 60629
Phone (773) 471-8000

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

333 Madison St
Joliet, IL 60435
Phone (815) 725-7222

20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857

Interoperability endpoints

  • Direct secure messaging: laura.kavlie.1@18377.direct.athenahealth.com

Organizations & group practices 7

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": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1184968646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 S OAK PARK AVE APT 2",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603042616",
            "telephone_number": "616-558-0693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 W 68TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606291813",
            "telephone_number": "773-884-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVLIE",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.