Individual provider Active NPI

Kelsey Olson, PA-C

  • Physician Assistant
  • Lake Barrington, IL
National Provider Identifier
1861084725
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085008139 Issued in IL
Practice address
22285 N Pepper Rd Ste 401
Lake Barrington, IL 60010-2542
Phone
(847) 882-6604
Fax
(847) 882-6228
NPI assigned
Feb 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085008139 IL Primary

Addresses

Primary practice location

22285 N Pepper Rd Ste 401
Lake Barrington, IL 60010-2542

Mailing address

22285 N Pepper Rd Ste 401
Lake Barrington, IL 60010-2542
Phone (847) 882-6604

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210318000662 IL Practitioner - Physician Assistant 1658788666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwest Neurology, LTDGroup PAC ID 8729069158, 30 clinicians

Practice addresses (Care Compare)

22285 N Pepper Rd
Suite 401
Lake Barrington, IL 60010-2542
Phone 84788266042191

3701 Algonquin Rd
Suite 800
Rolling Meadows, IL 60008-3154
Phone (847) 882-6604

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group PastSince Feb 1, 2021 Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1861084725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22285 N PEPPER RD STE 401",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600102542",
            "telephone_number": "847-882-6604",
            "fax_number": "847-882-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22285 N PEPPER RD STE 401",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600102542",
            "telephone_number": "847-882-6604",
            "fax_number": "847-882-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "KELSEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085008139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Barrington, IL

Sources for this page

Verify at the official NPI Registry.