Jesse Kelso

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

036165437 Issued in IL

Practice address

2650 Ridge Ave
Evanston, IL 60201-1700

Phone

(847) 982-6710

NPI assigned

Apr 17, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Internal Medicine

  Medicare reassignment NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Endeavor Health Clinical Operations

  • Psychiatric Hospital Unit
  • Highland Park, IL
  • NPI 1770527236
  NPD (past)

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

{
    "created_epoch": "1618617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1629659057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 SEARLE PKWY",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600775313",
            "telephone_number": "847-982-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-982-6710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371443",
            "country_code": "US",
            "telephone_number": "847-570-4789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1620 W Harrison St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123801",
            "country_code": "US",
            "telephone_number": "312-942-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELSO",
        "first_name": "JESSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-17",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036-165437",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036165437",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036-165437",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy B Kelly, MA
• Ashley E. Kelly, APN-CNP
• Derek Joseph Kelly, MD
• James Francis Kelly, DO
• Karen M. Kelly, PHARM.D.
• Elizabeth M Kelzer, PA-C
• Alexander Kemel, M.D.
• Kenemore and Associates, Inc.
• Ellen Kenemore, L.C.S.W.
• Thomas K. Kenemore, PH.D., LCSW

• Hospitalist Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Hospitalist Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.