Individual provider Active NPI

Keri Anne Brach, APRN

  • Family Nurse Practitioner
  • Evergreen Park, IL
National Provider Identifier
1437942448
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209032417 Issued in IL
Practice address
9760 S Kedzie Ave Ste 3
Evergreen Park, IL 60805-3184
Phone
(708) 423-6209
NPI assigned
May 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Flight Registered Nurse 163WF0300X 041332770 IL
Family Nurse Practitioner 363LF0000X 209032417 IL Primary

Addresses

Primary practice location

9760 S Kedzie Ave Ste 3
Evergreen Park, IL 60805-3184

Mailing address

9760 S Kedzie Ave Ste 3
Evergreen Park, IL 60805-3184
Phone (708) 423-6209

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
I20260519003377 IL Practitioner - Nurse Practitioner 2163918137 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9760 S Kedzie Ave
Suite 3
Evergreen Park, IL 60805-3184

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041332770ILMDFlight Registered Nurse
209032417ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Park Primary Care LTD Current Accepting new patients
Evergreen Care Center LTD CurrentSince May 25, 2025 Accepting new patients
The Headache Lab Current Accepting new patients

Locations

9760 S Kedzie Ave
Ste 3
Evergreen Pk, IL 60805
Phone (708) 423-6209

9760 S Kedzie Ave
Ste 2
Evergreen Pk, IL 60805
Phone (708) 423-8150

Interoperability endpoints

  • Direct secure messaging: keri.brach.1@27901.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1437942448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE STE 3",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053184",
            "telephone_number": "708-423-6209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE STE 3",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053184",
            "telephone_number": "708-423-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACH",
        "first_name": "KERI",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WF0300X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Flight",
            "state": "IL",
            "license": "041332770",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209032417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.