Kelly Suzanne Garcia, BSN, RN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.024727 Issued in IL

Practice address

600 Enterprise Dr
Oak Brook, IL 60523-1922

Phone

(312) 728-4728

NPI assigned

Jan 30, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kelly Suzanne O'Donnell Former name

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tamid Medical GroupGroup PAC ID 4587560594, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Luxe Home Health Home health agency, Des Plaines, IL, CCN 148317

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

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.

• Tamid Medical Group

  • Internal Medicine Physician
  • Riverwoods, IL
  • NPI 1689744245
  Medicare reassignment Care Compare group NPD
• Prime Care LTC Consulting Inc

  • Internal Medicine Physician
  • Northlake, IL
  • NPI 1487075073
  NPD

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

• Whole Life Home Health LLC

  • Home Health Agency
  • Des Plaines, IL
  • NPI 1417189838
  Care Compare affiliation

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

{
    "created_epoch": "1643500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643500800000",
    "number": "1881347946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 PAPOOSE CT",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601881431",
            "telephone_number": "708-769-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231922",
            "telephone_number": "312-728-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "KELLY",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "BSN, RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-30",
        "last_updated": "2022-01-30",
        "certification_date": "2022-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.024727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "O'DONNELL",
            "middle_name": "SUZANNE",
            "prefix": "MS.",
            "credential": "BSN, RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Manish R Gandhi, DDS
• Nayan V Gandhi, M.D.
• Mark Robert Gannon, PT
• Mary L. Gannon, M.D.,C.A.D.C.
• Jessica L Garcia, MD
• Isaiah V Gardiner
• Beth Gasaway, LCPC
• Samanthia Gaspar
• Gavin Scoliosis and Spine Center, LLC
• Thomas Gavin, CO/LO

• Family Nurse Practitioner in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.