Individual provider Active NPI

Kelly Rhodes

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1639691090
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036.152990 Issued in IL
Practice address
2150 W Harrison St
RM. 256
Chicago, IL 60612
Phone
(312) 942-2099
Fax
(312) 942-3186
NPI assigned
Jul 7, 2017
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036.152990 IL Primary

Addresses

Primary practice location

2150 W Harrison St
RM. 256
Chicago, IL 60612

Mailing address

2150 W Harrison St RM 256
Chicago, IL 60612-3706
Phone (312) 563-1835

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
I20210429000459 IL Practitioner - Psychiatry 6103235320 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Rush Medical College of Rush University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians
2014 Health LLCGroup PAC ID 2365764024, 22 clinicians

Practice addresses (Care Compare)

1645 W Jackson Blvd
Suite 602
Chicago, IL 60612-2847
Phone (312) 942-8387

555 Wilson LN
Des Plaines, IL 60016-4729
Phone (212) 243-5565

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.152990ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
2014 Health, LLC CurrentSince Mar 15, 2021 Accepting new patients
Rush University Medical Group CurrentSince Jul 1, 2021 Accepting new patients
Riverside Health System Psychiatry CurrentSince Jan 3, 2023 Accepting new patients
Riverside Health System CurrentSince Jan 3, 2023 Accepting new patients
Rush University Medical Center CurrentSince Jul 1, 2021 Accepting new patients

Locations

300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666

1645 W Jackson Blvd
Ste 602
Chicago, IL 60612
Phone (312) 942-8387

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

2150 W Harrison St
Rm 256
Chicago, IL 60612
Phone (312) 942-2099

75 Remittance Dr
Dept 1611
Chicago, IL 60675

555 Wilson Ln
Des Plaines, IL 60016
Phone (212) 243-5565

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1639691090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 W HARRISON ST RM 256",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123706",
            "telephone_number": "312-563-1835",
            "fax_number": "312-942-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 W HARRISON ST",
            "address_2": "RM. 256",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-942-2099",
            "fax_number": "312-942-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHODES",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.152990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.