Individual provider Active NPI

Carol Irene Kessel, PA-C

  • Physician Assistant
  • Waukegan, IL
National Provider Identifier
1609490952
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.008475 Issued in IL
Practice address
2615 Washington St
Waukegan, IL 60085-4980
Phone
(847) 360-2860
NPI assigned
Jun 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.008475 IL Primary

Addresses

Primary practice location

2615 Washington St
Waukegan, IL 60085-4980

Mailing address

2615 Washington St
Waukegan, IL 60085-4980
Phone (847) 360-2860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI, AZ3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20221101000239 IL Practitioner - Physician Assistant 0042687238 Reassigns benefits to 2 organizations
I20240321003506 WI Practitioner - Physician Assistant 0042687238 Reassigns benefits to 1 organization
I20251015003772 AZ Practitioner - Physician Assistant 0042687238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ganesha Institute of Neurology and Psychiatry SCGroup PAC ID 0042432296, 25 clinicians

Practice addresses (Care Compare)

101 N Colorado St
Chandler, AZ 85225-5534
Phone (847) 816-6335

1860 W Winchester Rd
Suite 106
Libertyville, IL 60048-5312
Phone (847) 816-6335

4600 Green Bay Rd
Kenosha, WI 53144-1719
Phone (847) 816-6335

9327 N 3Rd St
Suite 200
Phoenix, AZ 85020-2473
Phone (520) 595-5500

Hospital & facility affiliations

  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
  • Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021
  • Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.008475ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ganesha Institute of Neurology and Psychiatry SC Physician Assistant CurrentSince Jun 15, 2022 Accepting new patients
Ganesha Institute of Neurology and Psychiatry SC Physician Assistant CurrentSince Jun 15, 2022 Accepting new patients

Locations

9327 N 3rd St
Ste 200
Phoenix, AZ 85020
Phone (520) 595-5500

1850 W Winchester Rd
Ste 115
Libertyville, IL 60048
Phone (847) 816-6335

1860 W Winchester Rd
Ste 106
Libertyville, IL 60048
Phone (847) 599-0715

4600 Green Bay Rd
Kenosha, WI 53144
Phone (847) 816-6335

Interoperability endpoints

  • Direct secure messaging: carol.jandron.1@9664.direct.athenahealth.com

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 5

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": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1609490952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 WASHINGTON ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854980",
            "telephone_number": "847-360-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 WASHINGTON ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854980",
            "telephone_number": "847-360-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSEL",
        "first_name": "CAROL",
        "middle_name": "IRENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.