Constance Patricia Kass

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085008654 Issued in IL

Practice address

9760 S Kedzie Ave
Evergreen Park, IL 60805-3109

Phone

(708) 423-8150

Fax

(708) 423-8152

NPI assigned

Aug 1, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: constance.kass.1@27901.direct.athenahealth.com

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.

• Park Primary Care LTD

  • General Practice Physician
  • Evergreen Park, IL
  • NPI 1891984068
  Medicare reassignment NPD (past)
• Evergreen Care Center LTD

  • General Practice Physician
  • Evergreen Park, IL
  • NPI 1447449616
  Medicare reassignment

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

{
    "created_epoch": "1627776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694822400000",
    "number": "1639842933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053109",
            "telephone_number": "708-423-8150",
            "fax_number": "708-423-8152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053109",
            "telephone_number": "708-423-8150",
            "fax_number": "708-423-8152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6264 Edgebrook Ln E",
            "address_purpose": "LOCATION",
            "city": "LA Grange",
            "state": "IL",
            "postal_code": "605256994",
            "country_code": "US",
            "telephone_number": "708-522-9251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9760 S Kedzie Ave",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608053109",
            "country_code": "US",
            "telephone_number": "708-423-8150",
            "fax_number": "708-423-8152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASS",
        "first_name": "CONSTANCE",
        "middle_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-01",
        "last_updated": "2023-09-16",
        "certification_date": "2023-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085008654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jung I Jun, MD SC
• Jung Il Jun MD SC
• Mohammad Tarek Kabbany, M.D.
• Margaret Rose Kane
• Ajita V. Kasbekar, M.D.
• Ibrahim Kassas, MD
• Kathy Abbott PSYD PC
• Bruce Terry Katz, O.D.
• Brenna Keaty, DPT
• Kedzie Medical Associates LTD

• Medical Physician Assistant in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2023; 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.