Individual provider Active NPI

Kassidy Hamm, FNP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1740093798
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209031237 Issued in IL
Practice address
5521 S Kedzie Ave Unit 106
Chicago, IL 60629-2448
Phone
(773) 306-2546
NPI assigned
Jan 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209031237 IL Primary

Addresses

Primary practice location

5521 S Kedzie Ave Unit 106
Chicago, IL 60629-2448

Mailing address

5521 S Kedzie Ave Unit 106
Chicago, IL 60629-2448
Phone (773) 306-2546

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
I20250305002422 IL Practitioner - Nurse Practitioner 9830610930 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 2, IncGroup PAC ID 0547495467, 221 clinicians

Practice addresses (Care Compare)

40 75TH St
Willowbrook, IL 60527-2325
Phone (630) 581-5372

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209031237ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Feb 4, 2025 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Feb 4, 2025 Accepting new patients

Locations

5521 S Kedzie Ave
Unit 106
Chicago, IL 60629
Phone (773) 306-2546

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1738281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1740093798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5521 S KEDZIE AVE UNIT 106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606292448",
            "telephone_number": "773-306-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5521 S KEDZIE AVE UNIT 106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606292448",
            "telephone_number": "773-306-2546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMM",
        "first_name": "KASSIDY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209031237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.