Individual provider Active NPI

Keimia Mehrabian, FNP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1194547976
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209030620 Issued in IL
Practice address
1725 W Harrison St Ste 1159
Chicago, IL 60612-3883
Phone
(312) 942-5020
NPI assigned
Oct 31, 2024
Reactivated
Jan 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209030620 IL Primary

Addresses

Primary practice location

1725 W Harrison St Ste 1159
Chicago, IL 60612-3883

Mailing address

2333 W Saint Paul Ave Apt 209
Chicago, IL 60647-5342
Phone (832) 294-8742

Other practice location 1

675 N Saint Clair St
Chicago, IL 60611-5975
Phone (312) 664-3278

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
I20250217000263 IL Practitioner - Nurse Practitioner 7618407966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1725 W Harrison St
Suite 1159
Chicago, IL 60612-3883
Phone (312) 942-5020

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Jan 7, 2025 Accepting new patients
Rush University Medical Center CurrentSince Jan 7, 2025 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1725 W Harrison St
Ste 1159
Chicago, IL 60612
Phone (312) 942-5020

1725 W Harrison St
Ste 838
Chicago, IL 60612
Phone (312) 421-2010

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1194547976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 W SAINT PAUL AVE APT 209",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475342",
            "telephone_number": "832-294-8742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 1159",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123883",
            "telephone_number": "312-942-5020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 N Saint Clair St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606115975",
            "country_code": "US",
            "telephone_number": "312-664-3278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHRABIAN",
        "first_name": "KEIMIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "deactivation_date": "2024-12-30",
        "reactivation_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209030620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.