Ellen Kennelly, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209010942 Issued in IL

Practice address

430 Warrenville Rd Ste 230
Lisle, IL 60532-1348

Phone

(888) 693-6437

Fax

(630) 432-6227

NPI assigned

Jan 28, 2014

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

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ekennelly176913@uihealth.direct-ci.com

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.

• Dupage Medical Group LTD

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  Medicare reassignment Care Compare group NPD
• The Board of Trustees of the University of Illinois

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1669493466
  Medicare reassignment Care Compare group NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1912283110
  Medicare reassignment NPD
• Mount Sinai Community Foundation

  • Rehabilitation Hospital
  • Chicago, IL
  • NPI 1376715896
  Medicare reassignment NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1164944369
  NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Springfield, IL
  • NPI 1871360297
  NPD
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD
• Mount Sinai Community Foundation

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1144383084
  NPD
• Mount Sinai Community Foundation

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1982657854
  NPD
• The Board of Trustees of the University of Illinois

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  • Federally Qualified Health Center (FQHC)
  • Rockford, IL
  • NPI 1306486022
  NPD
• Board of Trustees of the University of Illinois

  • Pediatrics Physician
  • Peoria, IL
  • NPI 1467425322
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Board of Trustees of the University of Illinois

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1861431751
  Care Compare affiliation

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1376966333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 WARRENVILLE RD STE 230",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321348",
            "telephone_number": "888-693-6437",
            "fax_number": "630-432-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNELLY",
        "first_name": "ELLEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-28",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209010942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lee Kassir, M.D.
• Beth Kathan
• Katherine Borchardt, Psy.D., P.C.
• Lateef Kelani, PMHNP-BC
• Laurie K Kelly, LCSW
• Laura Elizabeth Kenter, M.S., A.T.C.
• Kett Counseling and Educational Services, LLC
• Asma Khalid, MD
• Omer N Khan, DMD
• Nina W Khazen, MD

• Family Nurse Practitioner in Lisle, IL
• Providers in Lisle, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.