Individual provider Active NPI

Kelly Collins, FNP-BC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1710414396
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015242 Issued in IL
Practice address
2320 E 93Rd St
Chicago, IL 60617-3909
Phone
(773) 967-5430
NPI assigned
May 15, 2017
Last updated
Aug 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209015242 IL Primary

Addresses

Primary practice location

2320 E 93Rd St
Chicago, IL 60617-3909

Mailing address

29373 Network PL
Chicago, IL 60673-2919
Phone (847) 390-5900

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kcollins205749@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20170823001248 IL Practitioner - Nurse Practitioner 4385916568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, shared by 24 NPIs, 1,134 clinicians

Practice addresses (Care Compare)

1220 S Wood St
Chicago, IL 60608-1202
Phone (312) 413-3282

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jan 29, 2020 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jun 5, 2021 Accepting new patients
Board of Trustees of the University of Illinois CurrentSince Jan 29, 2020 Accepting new patients

Locations

1220 S Wood St
Chicago, IL 60608
Phone (312) 413-1261

2320 E 93rd St
Chicago, IL 60617
Phone (773) 967-2000

7702 Solution Ctr
Chicago, IL 60677

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

7732 Solutions Ctr
Chicago, IL 60677

8131 S May St
Chicago, IL 60620
Phone (312) 365-5801

Interoperability endpoints

  • Direct secure messaging: kcollins19246@uihealth.direct-ci.com
  • Direct secure messaging: kcollins205749@direct.myadvocateaurora.org

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 1

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": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1710414396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606732919",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 E 93RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606173909",
            "telephone_number": "773-967-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "KELLY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-15",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcollins205749@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2320 E 93rd St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606173909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2320 E 93rd St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606173909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.