Individual provider Active NPI

Keena Maureen Kohl

  • Student in an Organized Health Care Education/Training Program
  • Chicago, IL
National Provider Identifier
1861059206
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone
(312) 942-3134
NPI assigned
May 21, 2019
Last updated
May 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1653 W Congress Pkwy
Chicago, IL 60612-3833

Mailing address

1653 W Congress Pkwy
Chicago, IL 60612-3833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20230925003374 CA Practitioner - Anesthesiology 8123355641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Anesthesia Medical Group IncGroup PAC ID 6103728407, 185 clinicians

Practice addresses (Care Compare)

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone (714) 871-3280

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Anesthesia Medical Group Inc CurrentSince May 13, 2024 Accepting new patients
Anesthesia & Analgesia Medical Group, Inc. CurrentSince Aug 14, 2023 Accepting new patients

Locations

1124 S Main St
Ste 101
Corona, CA 92882
Phone (951) 737-6363

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

1000 Trancas St
Napa, CA 94558
Phone (707) 226-2901

455 S Main St
Orange, CA 92868
Phone (714) 289-4511

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1861059206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHL",
        "first_name": "KEENA",
        "middle_name": "MAUREEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.