Individual provider Active NPI

Jennifer Lee Kassir, M.D.

  • Internal Medicine Physician
  • Lisle, IL
National Provider Identifier
1528214715
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.120590 Issued in IL
Practice address
430 Warrenville Rd
Ste 210
Lisle, IL 60532-1348
Phone
(630) 432-6180
Fax
(630) 432-6181
NPI assigned
Aug 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 036120590 IL
Internal Medicine Physician 207R00000X 036.120590 IL Primary

Addresses

Primary practice location

430 Warrenville Rd
Ste 210
Lisle, IL 60532-1348

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-0018
Phone (630) 469-9200

Other identifiers 1

IdentifierTypeStateIssuer
036120590MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jbrown11713@direct.edward.org
Direct Messaging Address jkassir11713@dulyhealthandcare.direct-ci.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090212000201 IL Practitioner - Internal Medicine 7618032392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.120590ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Sep 15, 2010 Accepting new patients
Central Dupage Physician Group CurrentSince Feb 18, 2009 Accepting new patients
Central Dupage Physician Group Internal Medicine CurrentSince Feb 18, 2009 Accepting new patients
Dupage Medical Group LTD CurrentSince Sep 15, 2010 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

Dept 5777
Carol Stream, IL 60122

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

430 Warrenville Rd
#210
Lisle, IL 60532
Phone (630) 432-6180

430 Warrenville Rd
Lisle, IL 60532
Phone (630) 432-6180

430 Warrenville Rd
Ste 210
Lisle, IL 60532
Phone (630) 432-6180

636 Raymond Dr
Ste 200
Naperville, IL 60563
Phone (630) 355-5302

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1528214715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740018",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 WARRENVILLE RD",
            "address_2": "STE 210",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321348",
            "telephone_number": "630-432-6180",
            "fax_number": "630-432-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSIR",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036120590",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.120590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036120590",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbrown11713@direct.edward.org",
            "affiliation": "N",
            "address_1": "430 Warrenville Rd",
            "address_2": "Ste 210",
            "city": "Lisle",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605321348",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkassir11713@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "430 Warrenville Rd",
            "address_2": "Ste 210",
            "city": "Lisle",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605321348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

Verify at the official NPI Registry.