Brendan William Kelliher, NP -C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209010534 Issued in IL

Practice address

2525 S Michigan Ave
Chicago, IL 60616-2315

Phone

(312) 567-6093

NPI assigned

Jul 19, 2013

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  NPD (past)
• Paragon Clinical Midwest, LLC

  • Nurse Practitioner
  • Merrillville, IN
  • NPI 1619335700
  NPD (past)

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1861834855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20015 NEWTON WAY",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604487785",
            "telephone_number": "708-478-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162315",
            "telephone_number": "312-567-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLIHER",
        "first_name": "BRENDAN",
        "middle_name": "WILLIAM",
        "credential": "NP -C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-19",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209010534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regan Kelley, M.S.
• Rosemary Kelley, LCPC
• Sarah Kelley, PA
• Shannon Kelley
• Krystle Kellick, LCSW
• Dennis Robert Kellman, RPH
• Joshua Kellman, M.D.
• Suzanne Kellman, DMD
• Suzanne Kellman, M.D.
• David James Kellner

• Adult Health Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.