Active NPI
Mary McKenna, MD
- Obstetrics & Gynecology Physician
- Park Ridge, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 036.155532
- Practice address
- 1775 Dempster St
Park Ridge, IL 60068-1143 - Phone
- (847) 723-5986
- NPI assigned
- Mar 27, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Obstetrics & Gynecology Physician | 207V00000X | 036.155532 | IL | Primary |
Addresses
Primary practice location
1775 Dempster St
Park Ridge, IL 60068-1143
Mailing address
120 Osler Unit 100
Naperville, IL 60540-7429
Phone (630) 428-2229
Other practice location 1
2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-4033
Other practice location 2
120 Osler Unit 100
Naperville, IL 60540-7429
Phone (630) 428-2229
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mmckenna307309@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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Rush Medical College of Rush University, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1875 Dempster St
Suite 330
Park Ridge, IL 60068-1186
Phone (847) 655-8500
Hospital & facility affiliations
- Advocate Lutheran General Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.155532 | IL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health & Hospitals Corp. | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Charles E Miller M D SC | Past | Accepting new patients |
Locations
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
29373 Network Pl
Chicago, IL 60673
1875 Dempster St
Ste 330
Park Ridge, IL 60068
Phone (847) 655-8500
1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150
1700 Luther Ln
Ste 3150
Park Ridge, IL 60068
Phone (847) 593-1040
Interoperability endpoints
- mmckenna307306@direct.myadvocateaurora.org
- mmckenna307309@direct.myadvocateaurora.org
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.
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1750315545
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- Reproductive Endocrinology Physician
- Naperville, IL
- NPI 1639203516
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Park Ridge, IL
- NPI 1164539730
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702252800000",
"number": "1760913032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 OSLER UNIT 100",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605407429",
"telephone_number": "630-428-2229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1775 DEMPSTER ST",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681143",
"telephone_number": "847-723-5986"
}
],
"practiceLocations": [
{
"address_1": "2160 S 1st Ave",
"address_purpose": "LOCATION",
"city": "Maywood",
"state": "IL",
"postal_code": "601533328",
"country_code": "US",
"telephone_number": "708-216-4033",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "120 Osler Unit 100",
"address_purpose": "LOCATION",
"city": "Naperville",
"state": "IL",
"postal_code": "605407429",
"country_code": "US",
"telephone_number": "630-428-2229",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCKENNA",
"first_name": "MARY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-27",
"last_updated": "2023-12-11",
"certification_date": "2023-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "036.155532",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mmckenna307309@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1775 Dempster St",
"city": "Park Ridge",
"state": "IL",
"country_code": "US",
"postal_code": "600681143",
"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": "1775 Dempster St",
"city": "Park Ridge",
"state": "IL",
"country_code": "US",
"postal_code": "600681143",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.