Individual provider Active NPI

Elizabeth A Kislov, FNP

  • Family Nurse Practitioner
  • Lincolnshire, IL
National Provider Identifier
1508524174
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209024449 Issued in IL
Practice address
207 Rivershire LN Apt 206
Lincolnshire, IL 60069-3808
Phone
(847) 338-1321
NPI assigned
Dec 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209024449 IL Primary

Addresses

Primary practice location

207 Rivershire LN Apt 206
Lincolnshire, IL 60069-3808

Mailing address

207 Rivershire LN Apt 206
Lincolnshire, IL 60069-3808
Phone (847) 338-1321

Other names 1

  • Elizabeth A Meshem Former name

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
I20220314000596 IL Practitioner - Nurse Practitioner 6901291780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

2919 W Addison St
Chicago, IL 60618-4635
Phone (877) 448-3627

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209024449ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osh-Il Physicians Group LLC Family CurrentSince Dec 1, 2021 Accepting new patients
Metro Infectious Disease Consultants LLC CurrentSince Dec 5, 2023 Accepting new patients
Metro Infectious Disease Consultants, LLC Current Accepting new patients
Metro Infectious Disease Consultants LLC CurrentSince Dec 5, 2023 Accepting new patients
Oak Street Health Physicians Group, PC Family CurrentSince Dec 1, 2021 Accepting new patients

Locations

400 Remington Blvd
Bolingbrook, IL 60440
Phone (630) 226-8100

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

310 W Plaza Dr
Carterville, IL 62918
Phone (618) 525-0719

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

180 N Michigan Ave
Ste 2220
Chicago, IL 60601
Phone (312) 236-4576

2919 W Addison St
Chicago, IL 60618
Phone (773) 205-4660

3433 W Madison St
Chicago, IL 60624
Phone (773) 242-2299

1435 N Randall Rd
Ste 404
Elgin, IL 60123
Phone (847) 741-5091

1300 Franklin Ave
Ste 230C
Normal, IL 61761
Phone (309) 585-6029

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1508524174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 RIVERSHIRE LN APT 206",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600693808",
            "telephone_number": "847-338-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 RIVERSHIRE LN APT 206",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600693808",
            "telephone_number": "847-338-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISLOV",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "MESHEM",
            "middle_name": "A",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincolnshire, IL

Sources for this page

Verify at the official NPI Registry.