Haley Rose Radev

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085011853 Issued in IL

Practice address

300 Riverside Dr Ste 2700
Bourbonnais, IL 60914-5071

Phone

(779) 701-2762

NPI assigned

Dec 29, 2025

Last updated

Mar 20, 2026By 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 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Riverside Health System

  • General Practice Physician
  • Kankakee, IL
  • NPI 1417061193
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1801752209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012901",
            "telephone_number": "815-935-7347",
            "fax_number": "815-936-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RIVERSIDE DR STE 2700",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609145071",
            "telephone_number": "779-701-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADEV",
        "first_name": "HALEY",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-29",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085011853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prime Healthcare Home Care LLC
• Provena Imaging Services Inc (Provena Health Center for Diagnostic Imaging)
• Provena St Marys Hospital
• Pulmonary & Critical Care Associates of Kankakee LTD
• Pure Growth Counseling PLLC
• Radiation Oncology of Kankakee
• Raffi Leblebijian
• Niveditha Rajagopalan, D.M.D.
• Erik Ranta, O.D.
• Issra Rashed, MD

• Physician Assistant in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; 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.

Verify at the official NPI Registry.