Individual provider Active NPI

Anna Grace Klevorn, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1205796661
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.011817 Issued in IL
Practice address
2835 N Sheffield Ave Ste 303
Chicago, IL 60657-5084
Phone
(773) 368-3164
NPI assigned
Nov 17, 2025
Last updated
Nov 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 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 085.011817 IL Primary

Addresses

Primary practice location

2835 N Sheffield Ave Ste 303
Chicago, IL 60657-5084

Mailing address

4222 N Ashland Ave Apt 101
Chicago, IL 60613-1278
Phone (773) 368-3164

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
I20260408002383 IL Practitioner - Physician Assistant 3678048576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2500 W Higgins Rd
Suite 1230
Hoffman Estates, IL 60169-2025

4222 N Ashland Ave
Apt 101
Chicago, IL 60613-1278

4222 N Ashland Ave Apt
Suite 101
Chicago, IL 60613-1278

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085.011817ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Gastro LLC CurrentSince Nov 24, 2025 Accepting new patients

Locations

2835 N Sheffield Ave
Ste 303
Chicago, IL 60657
Phone (773) 368-3164

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1763337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1205796661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 N ASHLAND AVE APT 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131278",
            "telephone_number": "773-368-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 N SHEFFIELD AVE STE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575084",
            "telephone_number": "773-368-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEVORN",
        "first_name": "ANNA",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-17",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.011817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.