Individual provider Active NPI

Kelly Blanche Allen, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Palos Heights, IL
National Provider Identifier
1316635220
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209027148 Issued in IL
Practice address
7300 W College Dr Ste 102
Palos Heights, IL 60463-1181
Phone
(708) 840-3733
NPI assigned
Apr 27, 2023
Last updated
Aug 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209027148 IL Primary

Addresses

Primary practice location

7300 W College Dr Ste 102
Palos Heights, IL 60463-1181

Mailing address

1427 Champlain St
Ottawa, IL 61350-2403
Phone (219) 921-6844

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
I20250416001764 IL Practitioner - Nurse Practitioner 3971028598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yusuf Salah LLCGroup PAC ID 3577895176, 45 clinicians

Practice addresses (Care Compare)

7300 W College Dr
Suite 101
Palos Heights, IL 60463-1181
Phone (708) 448-8470

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209027148ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yusuf Salah LLC Family CurrentSince Feb 13, 2025 Accepting new patients
Palos Psychiatric & Recovery Inst LTD Past Accepting new patients

Locations

19550 Governors Hwy
Flossmoor, IL 60422
Phone (708) 799-8400

6321 Dempster St
Morton Grove, IL 60053

7300 W College Dr
Ste 101
Palos Heights, IL 60463
Phone (708) 448-8470

7300 W College Dr
Ste 102
Palos Heights, IL 60463
Phone (312) 659-9698

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1316635220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1427 CHAMPLAIN ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613502403",
            "telephone_number": "219-921-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 W COLLEGE DR STE 102",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631181",
            "telephone_number": "708-840-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "KELLY",
        "middle_name": "BLANCHE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-27",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209027148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.