Individual provider Active NPI

Jordan R Keller, FNP-BC

  • Family Nurse Practitioner
  • Oak Park, IL
National Provider Identifier
1386318947
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.023699 Issued in IL
Practice address
18 Chicago Ave
Oak Park, IL 60302-2402
Phone
(773) 253-3933
Fax
(773) 437-6780
NPI assigned
Aug 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.023699 IL Primary

Addresses

Primary practice location

18 Chicago Ave
Oak Park, IL 60302-2402

Mailing address

PO Box 746715
Atlanta, GA 30374-6715
Phone (773) 253-3933

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
I20211004001450 IL Practitioner - Nurse Practitioner 7911305099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health Physicians Group PCGroup PAC ID 7517109879, 227 clinicians

Practice addresses (Care Compare)

1715 E 95TH St
Chicago, IL 60617-4708
Phone (312) 733-9730

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.023699ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group, PC Family CurrentSince Sep 1, 2021 Accepting new patients
Osh-Il Physicians Group LLC Family PastSince Jan 17, 2017 Accepting new patients

Locations

4318 S State St
Chicago, IL 60609
Phone (773) 285-9304

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

1715 E 95th St
Chicago, IL 60617
Phone (773) 768-4437

18 Chicago Ave
Oak Park, IL 60302
Phone (773) 253-3933

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1386318947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746715",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746715",
            "telephone_number": "773-253-3933",
            "fax_number": "773-437-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CHICAGO AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022402",
            "telephone_number": "773-253-3933",
            "fax_number": "773-437-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JORDAN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-05",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.023699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.