NPIMap

Individual provider Active NPI

Kathleen Elizabeth Andel, PA-C

  • Physician Assistant
  • Grayslake, IL
National Provider Identifier
1831463231
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085004295 Issued in IL
Practice address
1475 E Belvidere Rd
Grayslake, IL 60030-2012
Phone
(847) 582-2134
Fax
(847) 535-7285
NPI assigned
Mar 2, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 16

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty Foundation 4,386 clinicians

Practice addresses (Care Compare)

1200 N Westmoreland Rd
Suite 100
Lake Forest, IL 60045-1601
Phone (847) 735-8500

1475 E Belvidere Rd
Grayslake, IL 60030-2012

350 S Waukegan
Suite 150
Deerfield, IL 60015-5239
Phone (312) 926-3107

350 S Waukegan Rd
Deerfield, IL 60015-5239
Phone (312) 926-6146

6155 Grand Ave
Gurnee, IL 60031-1651

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20230921003534 IL Practitioner - Physician Assistant 1153582176 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085004295ILMDPhysician Assistant
PA07666TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 4, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 4, 2023 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

2701 Patriot Blvd
Glenview, IL 60026
Phone (847) 724-4536

1475 E Belvidere Rd
Grayslake, IL 60030
Phone (847) 535-8800

1000 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6150

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085004295 IL Primary
Physician Assistant 363A00000X PA07666 TX

Addresses

NPPES NPI Registry

Primary practice location

1475 E Belvidere Rd
Grayslake, IL 60030-2012

Mailing address

1475 E Belvidere Rd
Grayslake, IL 60030-2012
Phone (847) 582-2134

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
875N69OtherTXBCBS
293923301MedicaidTX

Other names 1

NPPES NPI Registry
  • Kathleen Elizabeth Lieberman Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 3, 2024.

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1831463231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 E BELVIDERE RD",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302012",
            "telephone_number": "847-582-2134",
            "fax_number": "847-535-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 E BELVIDERE RD",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302012",
            "telephone_number": "847-582-2134",
            "fax_number": "847-535-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDEL",
        "first_name": "KATHLEEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004295",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07666",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "875N69",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "293923301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "LIEBERMAN",
            "middle_name": "ELIZABETH",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grayslake, IL

Sources for this page

Verify at the official NPI Registry.