Individual provider Active NPI

Kellyn Marks, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1215973599
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Practice address
201 E Huron St
12TH FL Suite 105
Chicago, IL 60611-3197
Phone
(312) 926-5111
NPI assigned
Jun 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X IL Primary

Addresses

Primary practice location

201 E Huron St
12TH FL Suite 105
Chicago, IL 60611-3197

Mailing address

201 E Huron St
12TH FL Suite 105
Chicago, IL 60611-3197

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101012001317 IL Practitioner - Internal Medicine 8729270434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1333 W Belmont Ave
Chicago, IL 60657-5785

150 E Huron St
Suite 1100
Chicago, IL 60611-2948
Phone (312) 926-3627

2701 Patriot Blvd
Glenview, IL 60026-8039
Phone (847) 998-9910

350 S Waukegan
Suite 150
Deerfield, IL 60015-5239
Phone (312) 926-3107

350 S Waukegan Rd
Deerfield, IL 60015-5239
Phone (312) 926-6146

4445 W Irving Park Rd
Chicago, IL 60641-2808

4732 N Lincoln Ave
Chicago, IL 60625-8561
Phone (847) 475-2273

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

676 N Saint Clair St
Suite 415
Chicago, IL 60611-3133
Phone (312) 694-4101

800 N W Moreland Rd
Suite 102
Lake Forest, IL 60045-1687
Phone (847) 582-2104

800 N Westmoreland Rd
Suite 201
Lake Forest, IL 60045-1687
Phone (847) 535-7647

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-092837ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2014 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2014 Accepting new patients
Northwestern Memorial Physicians Group Internal Medicine CurrentSince Nov 16, 1995 Accepting new patients
Central Dupage Physician Group Internal Medicine Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

111 W Washington St
Ste 1801
Chicago, IL 60602
Phone (312) 726-8800

201 E Huron St
Fl 12
Chicago, IL 60611
Phone (312) 926-3642

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

75 Remittance Dr
Dept 1293
Chicago, IL 60675
Phone (312) 926-3642

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 4

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 7

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215973599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E HURON ST",
            "address_2": "12TH FL SUITE 105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E HURON ST",
            "address_2": "12TH FL SUITE 105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113197",
            "telephone_number": "312-926-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "KELLYN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.