Active NPI
Kristine Elizabeth Burgess, MS, PA-C
- Physician Assistant
- Lake Zurich, IL
National Provider Identifier
1720398100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.003787
- Practice address
- 350 Surryse Rd
Suite 100
Lake Zurich, IL 60047-3217 - Phone
- (847) 438-2144
- Fax
- (847) 719-0335
- NPI assigned
- Oct 19, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.003787 | IL | Primary |
Addresses
Primary practice location
350 Surryse Rd
Suite 100
Lake Zurich, IL 60047-3217
Mailing address
350 Surryse Rd
Suite 100
Lake Zurich, IL 60047-3217
Phone (847) 438-2144
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.003787 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Global Care S.C. | Past | Accepting new patients | |
| Waukegan Clinic Corp | Past | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Past | Accepting new patients |
Interoperability endpoints
- kristine.burgess.1@3569.direct.athenahealth.com
- https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Advocate Medical Group
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
dba Illinois Cardiovascular Specialists
- Interventional Cardiology Physician
- Barrington, IL
- NPI 1033309042
-
- Family Medicine Physician
- Waukegan, IL
- NPI 1306937289
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350259200000",
"number": "1720398100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 SURRYSE RD",
"address_2": "SUITE 100",
"city": "LAKE ZURICH",
"state": "IL",
"postal_code": "600473217",
"telephone_number": "847-438-2144",
"fax_number": "847-719-0335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 SURRYSE RD",
"address_2": "SUITE 100",
"city": "LAKE ZURICH",
"state": "IL",
"postal_code": "600473217",
"telephone_number": "847-438-2144",
"fax_number": "847-719-0335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "KRISTINE",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "MS, PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-19",
"last_updated": "2012-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.003787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Zurich, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.