Active NPI
Kelly Christine Clemens, FNP-BC
- Family Nurse Practitioner
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2019034308
- Practice address
- 1801 W Taylor St
Chicago, IL 60612-4795 - Phone
- (312) 355-1625
- Fax
- (312) 355-1515
- NPI assigned
- Jun 26, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041.422691 | IL | |
| Family Nurse Practitioner | 363LF0000X | 2019034308 | IL | Primary |
Addresses
Primary practice location
1801 W Taylor St
Chicago, IL 60612-4795
Mailing address
1801 W Taylor St
Chicago, IL 60612-4795
Phone (312) 996-9501
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1801 W Taylor St
Chicago, IL 60612-4795
845 W Wilson Ave
Uic Medicine
Chicago, IL 60640-8090
Phone (312) 744-1295
Hospital & facility affiliations
- University of Illinois Hospital and Clinics
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.28 of 100
- Quality
- 73.53
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.73
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.422691 | IL | MD | Registered Nurse |
| 2019034308 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Health System | Current | Accepting new patients | |
| Riverside Health System | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| Board of Trustees of the University of Illinois | Past | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Past | Accepting new patients |
Locations
300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666
835 S Wolcott Ave
Rm W140
Chicago, IL 60612
845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295
1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700
7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290
5775 E State Route 113
Coal City, IL 60416
Phone (815) 634-0100
23120 S Lagrange Rd
Ste 200
Frankfort, IL 60423
Phone (815) 464-5440
105 S First St
Wilmington, IL 60481
Phone (815) 476-5210
Interoperability endpoints
- kwhite113255@uihealth.direct-ci.com
Organizations & group practices 7
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.
-
- Anatomic Pathology Physician
- Chicago, IL
- NPI 1386863819
-
- General Practice Physician
- Kankakee, IL
- NPI 1417061193
-
- Psychiatry Physician
- Kankakee, IL
- NPI 1336354430
-
- Occupational Medicine Physician
- Chicago, IL
- NPI 1043727571
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1609094739
-
- Pediatrics Physician
- Peoria, IL
- NPI 1467425322
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1134118649
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1861431751
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699401600000",
"number": "1508427949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 W TAYLOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124795",
"telephone_number": "312-996-9501",
"fax_number": "312-355-1515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 W TAYLOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124795",
"telephone_number": "312-355-1625",
"fax_number": "312-355-1515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENS",
"first_name": "KELLY",
"middle_name": "CHRISTINE",
"name_prefix": "Ms.",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-26",
"last_updated": "2023-11-08",
"certification_date": "2023-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041.422691",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "2019034308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.