Denis Keljalic, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

125.079648 Issued in IL

Practice address

1875 W Dempster St Ste 470
Park Ridge, IL 60068-1129

Phone

(847) 795-5865

NPI assigned

Mar 26, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1648252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1912657537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 W DEMPSTER ST STE 470",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681129",
            "telephone_number": "847-795-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 W DEMPSTER ST STE 470",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681129",
            "telephone_number": "847-795-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELJALIC",
        "first_name": "DENIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-26",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125.079648",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syed Hamza Kazmi
• Elizabeth J Keady, LPTA
• Elizabeth Keating, LPC
• Andrew Gilbert Keeney, DO
• Kaci Keleher, DO
• James D Keller, MD
• Robert Givens Kellogg, M.D.
• Maryann Kelly, M.D.
• Stephanie N Kemper, PT
• David Kempfert, PT, OT

• Psychiatry Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.