Individual provider Active NPI

Kathryn Swedlund, PA-C

  • Medical Physician Assistant
  • Chicago, IL
National Provider Identifier
1245568393
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085.005213 Issued in IL
Practice address
1900 W Polk St
Chicago, IL 60612-3723
Phone
(630) 864-0065
NPI assigned
Dec 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085.005213 IL Primary

Addresses

Primary practice location

1900 W Polk St
Chicago, IL 60612-3723

Mailing address

700 Commerce Dr
Ste 500
Oak Brook, IL 60523-8736
Phone (630) 205-6612

Other names 1

  • Kathryn George Former name

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
I20160901001955 IL Practitioner - Physician Assistant 6507907359 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.005213ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Feb 28, 2017 Accepting new patients
Cook County CurrentSince Feb 28, 2017 Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1900 W Polk St
Chicago, IL 60612
Phone (312) 864-0060

Organizations & group practices 5

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": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1245568393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 COMMERCE DR",
            "address_2": "STE 500",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238736",
            "telephone_number": "630-205-6612",
            "fax_number": "847-698-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W POLK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "630-864-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEDLUND",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.005213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "GEORGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.