Individual provider Active NPI

Kehinde Christiana Fagbemi, NP

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1912465303
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209018916 Issued in IL
Practice address
516 E 45TH St
Chicago, IL 60653-3421
Phone
(708) 662-0493
NPI assigned
Mar 5, 2019
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209018916 IL
Certified Registered Nurse Anesthetist 367500000X 209018916 IL Primary

Addresses

Primary practice location

516 E 45TH St
Chicago, IL 60653-3421

Mailing address

516 E 45TH St
Chicago, IL 60653-3421
Phone (708) 662-0493

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190605000165 IL Practitioner - Nurse Practitioner 5698008704
I20240827002509 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698008704 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Anesthesia Associates P CGroup PAC ID 0042118069, 53 clinicians
Ireland Anesthesia Management LLCGroup PAC ID 4284130345, 16 clinicians

Practice addresses (Care Compare)

1900 Silver Cross Blvd
New Lenox, IL 60451-9509
Phone (815) 300-1100

331 W Surf St
Suite 5800
Chicago, IL 60657-0084
Phone (580) 512-3684

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209018916ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
360 Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 26, 2024 Accepting new patients
Ireland Anesthesia Management LLC CurrentSince Sep 4, 2025 Accepting new patients
Allied Anesthesia Associates, P.C. CurrentSince May 17, 2025 Accepting new patients

Locations

403 S Kennedy Dr
Bradley, IL 60915
Phone (815) 928-9999

331 W Surf St
Ste 5800
Chicago, IL 60657
Phone (312) 896-7700

1900 Silver Cross Blvd
New Lenox, IL 60451
Phone (815) 300-7106

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

Organizations & group practices 3

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 2

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": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1912465303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 E 45TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533421",
            "telephone_number": "708-662-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E 45TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533421",
            "telephone_number": "708-662-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGBEMI",
        "first_name": "KEHINDE",
        "middle_name": "CHRISTIANA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209018916",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209018916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.