Kylie L Mack, PA-C
Individual provider Active NPI Physician Assistant · Geneva, IL
NPI 1467705392 · NPPES record last updated Feb 19, 2019
Key facts
- NPI
- 1467705392
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 085004411 (IL)
- Practice address
- 351 Delnor Dr #100
Geneva, IL 60134 - Phone
- (630) 262-1001
- Fax
- (630) 262-8065
- NPI assigned
- Oct 16, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Central Dupage Physician Group
Practice addresses (Care Compare)
1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800
Hospital & facility affiliations
- Northwestern Medicine Central Dupage Hospital
- Northwestern Medicine Delnor Community Hospital
- Northwestern Medicine Kishwaukee Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.19 of 100
- Quality
- 83.05
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.63 of 100
- Quality
- 88.47
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131023000381 | IL | Practitioner - Physician Assistant | 3870728116 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.004411 | IL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Faculty Foundation | Current |
Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current |
Accepting new patients | |
| Central Dupage Physician Group | Current |
Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
Carol Stream, IL 60122
Phone (630) 933-3300
1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521
351 Delnor Dr
Ste 300
Geneva, IL 60134
Phone (630) 262-1001
351 Delnor Dr
Ste 100
Geneva, IL 60134
Phone (630) 938-9900
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870
2001 S Wiesbrook Rd
Wheaton, IL 60189
Phone (630) 510-7666
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085004411 | IL | Yes |
| Medical Physician Assistant | 363AM0700X | 085.004411 | IL |
Addresses
Primary practice location
351 Delnor Dr #100
Geneva, IL 60134
Mailing address
351 Delnor Dr #100
Geneva, IL 60134
Phone (630) 262-1001
Other providers in Geneva, IL
- Luxottica of America Inc
- Lyle Skinner LTD.
- Lynnea Therapy Services, PLLC
- Sheena Macgowan
- Giselle Macias
- William J Mackin
- Marcia Macy
- Joseph S Madonia
- Lucia Magarzo
- Melissa Mahon
All providers in Geneva, IL · Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.