Individual provider Active NPI

Colleen E Kirby, PA-C

  • Physician Assistant
  • Lake Forest, IL
National Provider Identifier
1659072908
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085010611 Issued in IL
Practice address
800 N Westmoreland Rd Ste 102
Lake Forest, IL 60045-1687
Phone
(847) 535-6464
Fax
(847) 535-7723
NPI assigned
Mar 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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 085010611 IL Primary

Addresses

Primary practice location

800 N Westmoreland Rd Ste 102
Lake Forest, IL 60045-1687

Mailing address

800 N Westmoreland Rd Ste 102
Lake Forest, IL 60045-1687
Phone (847) 535-6464

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
I20250211000212 IL Practitioner - Physician Assistant 7012447782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

1000 N Westmoreland Rd
Pavillion B 3Rd FL
Lake Forest, IL 60045-1659
Phone (847) 535-8500

1000 Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

1475 E Belvidere Rd
Grayslake, IL 60030-2012

600 N Westmoreland Rd
Suite 1100
Lake Forest, IL 60045-1659
Phone (847) 535-9510

660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

800 N W Moreland Rd
Suite 102
Lake Forest, IL 60045-1687
Phone (847) 582-2104

800 N Westmoreland Rd
Suite 201
Lake Forest, IL 60045-1687
Phone (847) 535-7647

Hospital & facility affiliations

  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085010611ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Feb 3, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Feb 3, 2025 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

2701 Patriot Blvd
Glenview, IL 60026
Phone (847) 724-4536

1475 E Belvidere Rd
Ste 201
Grayslake, IL 60030
Phone (847) 295-1114

800 N Westmoreland Rd
Ste 102
Lake Forest, IL 60045
Phone (847) 295-1300

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

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": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1659072908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD STE 102",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451687",
            "telephone_number": "847-535-6464",
            "fax_number": "847-535-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD STE 102",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451687",
            "telephone_number": "847-535-6464",
            "fax_number": "847-535-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "COLLEEN",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085010611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.