Lisa Katherine Kearney, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019026123 Issued in IL

Practice address

4751 N Kedzie Ave
2ND Floor
Chicago, IL 60625

Phone

(312) 432-4360

NPI assigned

Aug 29, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 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: lkearney362365@direct.ochin.org

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.

• Erie Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1760499545
  Medicare reassignment NPD
• Erie Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1548062318
  NPD
• Erie Family Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1164713129
  NPD

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1376651232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 N FAIRFIELD AVE APT 2S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471863",
            "telephone_number": "773-292-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4751 N KEDZIE AVE",
            "address_2": "2ND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60625",
            "telephone_number": "312-432-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNEY",
        "first_name": "LISA",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-026123",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9184040",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew O Kearney
• Anna Kearney, PA
• Elizabeth Kearney, LCSW, CADC
• Elizabeth Mary Kearney, LCSW
• Laura Mary Kearney
• Neah Kearney
• Tracey Kearney, LCPC
• Christina Kearns Fitzgerald, MS, RD, LDN
• Elieke Demmer Kearns, RD
• Emily Keating, OTR/L

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.