Ayanna Jeannette McKinnon, M.D.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

036-138620 Issued in IL

Practice address

18 Chicago Ave
Oak Park, IL 60302

Phone

(773) 253-3933

Fax

(773) 437-6780

NPI assigned

Apr 15, 2011

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Osh-Il Physicians Group LLC

  • Primary Care Clinic/Center
  • East Saint Louis, IL
  • NPI 1265977698
  NPD

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1912297573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 CHICAGO AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022402",
            "telephone_number": "773-253-3933",
            "fax_number": "773-437-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CHICAGO AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "60302",
            "telephone_number": "773-253-3933",
            "fax_number": "773-437-6780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2285 Sequoia Dr",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605066209",
            "country_code": "US",
            "telephone_number": "630-859-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "AYANNA",
        "middle_name": "JEANNETTE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-15",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036-138620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036138620",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan McIntyre, LCPC
• Lauren Michelle McKeand, M.A., CCC-SLP
• Julia Patricia McKee-Nastase, L.C.P.C.
• Megan McKenzie
• Allison Nicole McKinley, DPT
• Melissa McMahon, LCSW
• William P McMiller, M.D.
• Mary McNally, DPT
• Johnetta McNeal
• Elizabeth Agnes McNeilly

• Geriatric Medicine (Family Medicine) Physician in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Geriatric Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; 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.