Kelsey M Bacidore, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036172511 Issued in IL

Practice address

2160 S 1St Ave
Maywood, IL 60153-3328

Phone

(888) 584-7888

NPI assigned

Mar 22, 2022

Last updated

Aug 17, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kelsey Marie Johnson Other 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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117
• Loyola University Medical Center Hospital, Maywood, IL, CCN 140276

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbacidore162342@direct.luhs.org

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.

• Loyola University Medical Center

  • General Practice Physician
  • Maywood, IL
  • NPI 1336159961
  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  dba Mulcahy Pharmacy

  • Community/Retail Pharmacy
  • Maywood, IL
  • NPI 1184789299
  NPD
• Loyola University Medical Center

  dba Foster G. McGaw Hospital

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD

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

• Loyola University Medical Center

  dba Foster G. McGaw Hospital

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  Care Compare affiliation
• Loyola University Medical Center

  dba Loyola University Medical Center Cancer Center

  • General Acute Care Hospital
  • Tinley Park, IL
  • NPI 1427752013
  Care Compare affiliation
• Resurrection Medical Center - Chicago LLC

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1811735228
  Care Compare affiliation

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1932858230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "888-584-7888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Kish Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Dekalb",
            "state": "IL",
            "postal_code": "601159602",
            "country_code": "US",
            "telephone_number": "815-766-7334",
            "fax_number": "815-766-9768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACIDORE",
        "first_name": "KELSEY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036172511",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.080549",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "JOHNSON",
            "middle_name": "MARIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Taysir Walid Awad, M.D
• Oluwaseyi Awonusi
• Tariku T Ayele
• Yusouf A Ayesh, DPM
• David Porter Babcock, MD
• Vicki Ann Bacidore, APN
• Thomas Evan Backeris, DMD
• Annemarie Badalamenti, DDS
• Ifra Badar, MD
• Linda Bade, CRNA

• Emergency Medicine Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.