Jacara Kelley-Muhammad, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036131286 Issued in IL

Practice address

1111 Superior St Ste 101
Melrose Park, IL 60160-4100

Phone

(708) 406-3040

NPI assigned

Jun 23, 2009

Last updated

Dec 24, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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

• PCC Community Wellness Center

  dba PCC Austin Dental & Specialty Care Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1134954506
  NPD
• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Oak Park, IL
  • NPI 1871516799
  NPD
• Browne Medical, LLC

  • Urgent Care Clinic/Center
  • West Orange, NJ
  • NPI 1871935353
  NPD (past)

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577145600000",
    "number": "1689802282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022606",
            "telephone_number": "708-383-0113",
            "fax_number": "708-383-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SUPERIOR ST STE 101",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601604100",
            "telephone_number": "708-406-3040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Lake St",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603022606",
            "country_code": "US",
            "telephone_number": "708-383-0113",
            "fax_number": "708-383-9911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY-MUHAMMAD",
        "first_name": "JACARA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2019-12-24",
        "certification_date": "2019-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125057077",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036131286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle A. Kassen, M.D., MPH
• Jaya Kasturi, M.D.
• Kasturi, P.C.
• Anastasia Katopodis, CNM
• Tamayo Kawai, M.D.
• Karl Kettelhut, CRNA
• Khalil Y Karim, MD, SC
• Asmat Khan, MAFP
• Khurana Family Eyecare, PLLC
• Jacqueline Kibir-Evans

• Family Medicine Physician in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2019; 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.