Lance Kelly, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

036154058 Issued in IL

Practice address

2160 S 1St Ave
Maywood, IL 60153

Phone

(708) 216-9169

Fax

(708) 216-1249

NPI assigned

Mar 29, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allied Anesthesia Associates P CGroup PAC ID 0042118069, 53 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Allied Anesthesia Associates, P.C.

  • Interventional Pain Medicine Physician
  • Joliet, IL
  • NPI 1750330742

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

• Silver Cross Hospital & Medical Centers

  • Rehabilitation Hospital Unit
  • New Lenox, IL
  • NPI 1003933797
  Care Compare affiliation
• Silver Cross Hospital & Medical Centers

  • General Acute Care Hospital
  • New Lenox, IL
  • NPI 1568553519
  Care Compare affiliation

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656201600000",
    "number": "1831694892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "505-220-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-9169",
            "fax_number": "708-216-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2022-06-26",
        "certification_date": "2022-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125.072310",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036154058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lkelly93162@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jadah Keith
• Gail Kellberg, APN
• Jaclyn Kelley, MSN, FNP-BC
• Breanna Elizabeth-Howe Kellogg
• Elizabeth M Kelly, MSN
• Morgan Kelly
• Patrick Donovan Kelly, D.D.S.
• William Thomas Kelly III, DNP, RN, APN, AGACNP
• Jake Clifton Kelow III, LSW/CADC/ATE/COPD I
• Hannah Kempker, PHARMD

• Anesthesiology Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2022; 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.