Individual provider Active NPI

Kelly Ann Salazar, FNP

  • Family Nurse Practitioner
  • Maywood, IL
National Provider Identifier
1497192934
Registry record updated Oct 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209010361 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000
NPI assigned
May 23, 2013
Last updated
Oct 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209010361 IL Primary
Family Nurse Practitioner 363LF0000X 28166397A IN
Emergency Registered Nurse 163WE0003X 28166397A IN

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (219) 392-7200

Other practice location 1

4321 Fir St
East Chicago, IN 46312-3049
Phone (219) 392-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131025000746 IN Practitioner - Nurse Practitioner 0244465326 Reassigns benefits to 2 organizations
I20190515002209 IL Practitioner - Nurse Practitioner 0244465326 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pic Indiana PCGroup PAC ID 3476790239, 143 clinicians
Illinois Urgent Care Professionals PLLCGroup PAC ID 9830437946, 36 clinicians
Premier Urgent Care LLCGroup PAC ID 3072028422, 5 clinicians

Practice addresses (Care Compare)

1245 E Ireland Rd
Suite B
South Bend, IN 46614-3448
Phone (574) 312-7022

17960 Halsted St
Homewood, IL 60430-2014
Phone (708) 922-0911

3019 N National Rd
Columbus, IN 47203
Phone (708) 922-0911

4769 W Cermak Rd
Pad02B
Cicero, IL 60804-2508
Phone (312) 833-8338

924 W Pike St
Physicians Urgent Care
Goshen, IN 46526-2365
Phone (574) 312-7056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28166397AINMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Urgent Care LLC CurrentSince Jan 24, 2026 Accepting new patients
Illinois Urgent Care Professionals PLLC CurrentSince Jul 11, 2025 Accepting new patients
Pic Indiana PC CurrentSince Feb 12, 2024 Accepting new patients
Community Health Providers PLLC PastSince Dec 15, 2025 Accepting new patients

Locations

10834B S Doty Ave
Chicago, IL 60628
Phone (773) 995-9911

800 W Fulton Market
Fl 12
Chicago, IL 60607

4769 W Cermak Rd
#2B
Cicero, IL 60804
Phone (312) 833-8338

7444 W Wilson Ave
Ste 102
Harwood Hts, IL 60706
Phone 2249996997101

17960 Halsted St
Homewood, IL 60430
Phone (708) 923-0911

3019 N National Rd
Columbus, IN 47201
Phone (812) 314-7617

924 W Pike St
Goshen, IN 46526
Phone (574) 312-7056

1245 E Ireland Rd
#B
South Bend, IN 46614
Phone (574) 312-7022

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791504000000",
    "number": "1497192934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "219-392-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4321 Fir St",
            "address_purpose": "LOCATION",
            "city": "East Chicago",
            "state": "IN",
            "postal_code": "463123049",
            "country_code": "US",
            "telephone_number": "219-392-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-23",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209010361",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28166397A",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "IN",
            "license": "28166397A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.