Organization Active NPI

Sauganash Health Associates

  • Family Medicine Physician
  • Evanston, IL
National Provider Identifier
1487843496
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036063365 Issued in IL
Legal business name
SAUGANASH HEALTH ASSOCIATES
Practice address
800 Austin St Ste 157
Evanston, IL 60202-3452
Phone
(773) 293-3510
Fax
(773) 293-3514
NPI assigned
Oct 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Authorized official

Name
Dr. Derek J Kelly, MDNPI 1407989106
Title
Senior Partner
Phone
(773) 293-3510

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 036063365 IL Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 036065656 IL

Addresses

Primary practice location

800 Austin St Ste 157
Evanston, IL 60202-3452

Mailing address

800 Austin St Ste 157
Evanston, IL 60202-3452
Phone (773) 293-3510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120723000374 IL Part B Supplier - Clinic/Group Practice 6800052747 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

2740 W Foster Ave
Ste 209
Chicago, IL 60625
Phone (773) 293-3510

800 Austin St
Ste 157
Evanston, IL 60202
Phone (773) 293-3510

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769644800000",
    "number": "1487843496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST STE 157",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023452",
            "telephone_number": "773-293-3510",
            "fax_number": "773-293-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST STE 157",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023452",
            "telephone_number": "773-293-3510",
            "fax_number": "773-293-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAUGANASH HEALTH ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "773-293-3510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036063365",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036065656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.