Individual provider Active NPI

Kelly M. Vasquez, APN-CNP

  • Nurse Practitioner
  • Des Plaines, IL
National Provider Identifier
1609608090
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209030756 Issued in IL
Practice address
314 E Washington St
Des Plaines, IL 60016-3061
Phone
(773) 951-4511
NPI assigned
Aug 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209030756 IL Primary
Family Nurse Practitioner 363LF0000X 209.030756 IL

Addresses

Primary practice location

314 E Washington St
Des Plaines, IL 60016-3061

Mailing address

314 E Washington St
Des Plaines, IL 60016-3061
Phone (773) 951-4511

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
I20241022001927 IL Practitioner - Nurse Practitioner 1759813280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
G800
Evanston, IL 60201-1700
Phone (847) 570-2000

Hospital & facility affiliations

  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209030756ILMDNurse Practitioner
209.030756ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Oct 11, 2024 Accepting new patients
Endeavor Health Medical Group CurrentSince Oct 11, 2024 Accepting new patients

Locations

880 W Central Rd
Arlington Hts, IL 60005
Phone (847) 394-3553

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#G800
Evanston, IL 60201
Phone (847) 570-2639

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

Organizations & group practices 2

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 2

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": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1609608090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 E WASHINGTON ST",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600163061",
            "telephone_number": "773-951-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 E WASHINGTON ST",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600163061",
            "telephone_number": "773-951-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "KELLY",
        "middle_name": "M.",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209030756",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.030756",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

Verify at the official NPI Registry.