Suzanne Kellman, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.030342 Issued in IL

Practice address

2611 W Chicago Ave
Chicago, IL 60622-4519

Phone

(773) 969-5934

NPI assigned

Jul 27, 2015

Last updated

Dec 27, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: suzanne.kellmandmd.p29@direct.fhn-fqhc.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Asian Human Services Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1164439279
  Medicare reassignment NPD
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1013920750
  Medicare reassignment NPD
• Asian Human Services Family Health Center

  • Health Educator
  • Chicago, IL
  • NPI 1174874788
  NPD
• Asian Human Services Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Niles, IL
  • NPI 1891162962
  NPD
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1174552293
  NPD
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Round Lake, IL
  • NPI 1639588254
  NPD

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1356726806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 TRIPP AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224519",
            "telephone_number": "773-969-5934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8321 W Golf Rd",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "IL",
            "postal_code": "607141113",
            "country_code": "US",
            "telephone_number": "847-720-3504",
            "fax_number": "224-251-7476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLMAN",
        "first_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.030342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "skellman@communityhealth.org",
            "affiliation": "N",
            "endpointDescription": "Practice Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2611 W Chicago Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606224519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shannon Kelley
• Krystle Kellick, LCSW
• Brendan William Kelliher, NP -C
• Dennis Robert Kellman, RPH
• Joshua Kellman, M.D.
• Suzanne Kellman, M.D.
• David James Kellner
• Lauren Kells
• Kelly a Fallon DC LTD
• Kelly Chiropractic and Wellness Center S.C.

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.